How much rates vary
Facilitymedian $6 · 10th to 90th $5 to $60Professionalmedian $5 · 10th to 90th $4 to $9
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $5.50 | Facility | None | $4.37 | $4.37 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $5.50 Typical High $5.50 | Professional | None | $4.37 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.66 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.44 | $0.55 | $0.55 |
AmeriHealth Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $7.24 Median $8.91 Typical High $8.91 | Professional | None | $7.24 | $8.91 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $42.66 | Professional | None | $4.57 | $4.57 | $42.66 |
Emblem Health Setting Professional Modifier None Typical Low $8.51 Median $13.18 Typical High $15.49 | Professional | None | $8.51 | $13.18 | $15.49 |
Geisinger Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Geisinger Setting Professional Modifier None Typical Low $4.47 Median $5.50 Typical High $9.12 | Professional | None | $4.47 | $5.50 | $9.12 |
Independence Blue Cross Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Martin's Point Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
Martin's Point Setting Professional Modifier None Typical Low $4.37 Median $5.50 Typical High $5.50 | Professional | None | $4.37 | $5.50 | $5.50 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.66 | $0.83 | $0.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.44 | $0.55 | $0.55 |
Oscar Health Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $12.88 | Professional | None | $6.17 | $6.17 | $12.88 |
UPMC Health Plan Setting Facility Modifier None Typical Low $6.46 Median $28.84 Typical High $50.12 | Facility | None | $6.46 | $28.84 | $50.12 |
UPMC Health Plan Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $8.51 | Professional | None | $6.46 | $6.46 | $8.51 |
United Setting Professional Modifier None Typical Low $3.47 Median $4.47 Typical High $7.41 | Professional | None | $3.47 | $4.47 | $7.41 |
2 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | KX · Policy requirements met | $6.92 | $6.92 | $6.92 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $6.31 Median $6.76 Typical High $6.76 | Professional | KX · Policy requirements met | $6.31 | $6.76 | $6.76 |
Where Pennsylvania sits
The same service costs 4.2 times more in Hawaii than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Pennsylvania· 23rd of 51
$5.50
HI $15.85KY $3.80
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.