How much rates vary
Facilitymedian $9 · 10th to 90th $1 to $5,012Professionalmedian $2 · 10th to 90th $1 to $3
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 $1.29 Median $1.29 Typical High $1.58 | Facility | None | $1.29 | $1.29 | $1.58 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.58 Typical High $1.58 | Professional | None | $1.29 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.65 Median $0.79 Typical High $0.79 | Professional | 52 · Reduced service | $0.65 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.32 Typical High $0.32 | Professional | 53 · Discontinued | $0.26 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.19 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.13 | $0.16 | $0.16 |
AmeriHealth Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | None | $1.70 | $1.70 | $1.70 |
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 $2.34 Median $2.63 Typical High $2.63 | Professional | None | $2.34 | $2.63 | $2.63 |
Cigna Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Emblem Health Setting Professional Modifier None Typical Low $3.47 Median $3.89 Typical High $4.90 | Professional | None | $3.47 | $3.89 | $4.90 |
Geisinger Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
Geisinger Setting Professional Modifier None Typical Low $1.58 Median $1.74 Typical High $2.63 | Professional | None | $1.58 | $1.74 | $2.63 |
Martin's Point Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Facility | None | $1.29 | $1.29 | $1.29 |
Martin's Point Setting Professional Modifier None Typical Low $1.29 Median $1.58 Typical High $1.58 | Professional | None | $1.29 | $1.58 | $1.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.65 Median $0.79 Typical High $0.79 | Professional | 52 · Reduced service | $0.65 | $0.79 | $0.79 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.32 Typical High $0.32 | Professional | 53 · Discontinued | $0.26 | $0.32 | $0.32 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.19 | $0.24 | $0.24 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.13 | $0.16 | $0.16 |
Oscar Health Setting Professional Modifier None Typical Low $2.40 Median $3.72 Typical High $3.98 | Professional | None | $2.40 | $3.72 | $3.98 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1.74 Median $8.51 Typical High $14.79 | Facility | None | $1.74 | $8.51 | $14.79 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.51 | Professional | None | $1.74 | $1.74 | $2.51 |
United Setting Professional Modifier None Typical Low $1.12 Median $1.32 Typical High $1.86 | Professional | None | $1.12 | $1.32 | $1.86 |
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 A1 · Dressing, 1 wound Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | A1 · Dressing, 1 wound | $2.00 | $2.00 | $2.00 |
Highmark BCBS Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | A1 · Dressing, 1 wound | $1.95 | $1.95 | $1.95 |
Where Pennsylvania sits
The same service costs 2.6 times more in Hawaii than in Utah. 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
$1.58
HI $2.88UT $1.12
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.