How much rates vary
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 $30.90 Median $30.90 Typical High $38.90 | Facility | None | $30.90 | $30.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $38.90 | Professional | None | $30.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $4.68 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.16 | $3.89 | $3.89 |
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 $51.29 Median $63.10 Typical High $63.10 | Professional | None | $51.29 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $38.02 Typical High $38.02 | Facility | None | $34.67 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $295.12 | Professional | None | $32.36 | $32.36 | $295.12 |
Emblem Health Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $93.33 | Professional | None | $51.29 | $79.43 | $93.33 |
Geisinger Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Geisinger Setting Professional Modifier None Typical Low $31.62 Median $38.90 Typical High $64.57 | Professional | None | $31.62 | $38.90 | $64.57 |
Martin's Point Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $38.90 | Professional | None | $30.90 | $38.90 | $38.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $4.68 | $5.89 | $5.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.16 | $3.89 | $3.89 |
Oscar Health Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $95.50 | Professional | None | $43.65 | $66.07 | $95.50 |
UPMC Health Plan Setting Facility Modifier None Typical Low $45.71 Median $208.93 Typical High $354.81 | Facility | None | $45.71 | $208.93 | $354.81 |
UPMC Health Plan Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | None | $45.71 | $45.71 | $60.26 |
United Setting Professional Modifier None Typical Low $24.55 Median $31.62 Typical High $52.48 | Professional | None | $24.55 | $31.62 | $52.48 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | KX · Policy requirements met | $47.86 | $47.86 | $47.86 |
Where Pennsylvania sits
The same service costs 3.0 times more in Hawaii than in New Hampshire. 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· 22nd of 51
$38.90
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.