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 $7.76 Median $7.76 Typical High $9.77 | Facility | None | $7.76 | $7.76 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $9.77 Typical High $9.77 | Professional | None | $7.76 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.45 Typical High $1.45 | Professional | 55 · Aftercare only | $1.15 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.98 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.78 | $0.98 | $0.98 |
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 $12.59 Median $15.85 Typical High $15.85 | Professional | None | $12.59 | $15.85 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $9.55 Typical High $9.55 | Facility | None | $8.13 | $9.55 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $77.62 | Professional | None | $8.13 | $8.13 | $77.62 |
Emblem Health Setting Professional Modifier None Typical Low $14.79 Median $23.44 Typical High $26.92 | Professional | None | $14.79 | $23.44 | $26.92 |
Geisinger Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Geisinger Setting Professional Modifier None Typical Low $9.77 Median $11.22 Typical High $16.22 | Professional | None | $9.77 | $11.22 | $16.22 |
Martin's Point Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
Martin's Point Setting Professional Modifier None Typical Low $7.76 Median $9.77 Typical High $9.77 | Professional | None | $7.76 | $9.77 | $9.77 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.45 Typical High $1.45 | Professional | 55 · Aftercare only | $1.15 | $1.45 | $1.45 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.98 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.78 | $0.98 | $0.98 |
Oscar Health Setting Professional Modifier None Typical Low $15.85 Median $22.39 Typical High $23.99 | Professional | None | $15.85 | $22.39 | $23.99 |
UPMC Health Plan Setting Facility Modifier None Typical Low $11.22 Median $51.29 Typical High $89.13 | Facility | None | $11.22 | $51.29 | $89.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $15.14 | Professional | None | $11.22 | $11.22 | $15.14 |
United Setting Professional Modifier None Typical Low $6.03 Median $7.94 Typical High $13.18 | Professional | None | $6.03 | $7.94 | $13.18 |
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 $11.75 Median $11.75 Typical High $11.75 | Professional | KX · Policy requirements met | $11.75 | $11.75 | $11.75 |
Where Pennsylvania sits
The same service costs 2.2 times more in Kansas than in Connecticut. 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· 25th of 51
$9.77
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.