How much rates vary
Facilitymedian $6 · 10th to 90th $1 to $5,012Professionalmedian $1 · 10th to 90th $1 to $2
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 $0.85 Median $1.07 Typical High $8.91 | Facility | None | $0.85 | $1.07 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $0.85 Median $1.07 Typical High $1.07 | Professional | None | $0.85 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.43 Median $0.54 Typical High $0.54 | Professional | 52 · Reduced service | $0.43 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.17 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.13 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.09 | $0.11 | $0.11 |
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 $1.58 Median $1.74 Typical High $1.74 | Professional | None | $1.58 | $1.74 | $1.74 |
Cigna Setting Facility Modifier None Typical Low $1.07 Median $1.07 Typical High $1.07 | Facility | None | $1.07 | $1.07 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Emblem Health Setting Professional Modifier None Typical Low $2.34 Median $2.57 Typical High $3.31 | Professional | None | $2.34 | $2.57 | $3.31 |
Geisinger Setting Facility Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Facility | None | $1.78 | $1.78 | $1.78 |
Geisinger Setting Professional Modifier None Typical Low $1.07 Median $1.15 Typical High $1.78 | Professional | None | $1.07 | $1.15 | $1.78 |
Martin's Point Setting Facility Modifier None Typical Low $0.85 Median $8.91 Typical High $8.91 | Facility | None | $0.85 | $8.91 | $8.91 |
Martin's Point Setting Professional Modifier None Typical Low $0.85 Median $1.07 Typical High $1.07 | Professional | None | $0.85 | $1.07 | $1.07 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.43 Median $0.54 Typical High $0.54 | Professional | 52 · Reduced service | $0.43 | $0.54 | $0.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.17 | $0.22 | $0.22 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.13 | $0.16 | $0.16 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.09 | $0.11 | $0.11 |
Oscar Health Setting Professional Modifier None Typical Low $1.58 Median $2.51 Typical High $2.57 | Professional | None | $1.58 | $2.51 | $2.57 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1.26 Median $5.75 Typical High $10.00 | Facility | None | $1.26 | $5.75 | $10.00 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.66 | Professional | None | $1.26 | $1.26 | $1.66 |
United Setting Professional Modifier None Typical Low $0.76 Median $0.87 Typical High $1.29 | Professional | None | $0.76 | $0.87 | $1.29 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier A2 · Dressing, 2 wounds Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | A2 · Dressing, 2 wounds | $1.35 | $1.35 | $1.35 |
Where Pennsylvania sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 24th of 51
$1.07
ID $1.86CO $0.76
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.