How much rates vary
Facilitymedian $62 · 10th to 90th $45 to $1,479Professionalmedian $48 · 10th to 90th $35 to $62
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 $34.67 Median $37.15 Typical High $37.15 | Facility | None | $34.67 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $37.15 | Professional | None | $34.67 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.50 Typical High $5.62 | Professional | 55 · Aftercare only | $5.25 | $5.50 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $3.72 |
Aetna Setting Professional Modifier RR · Rental Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | RR · Rental | $3.55 | $3.55 | $3.55 |
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 $54.95 Median $60.26 Typical High $60.26 | Professional | None | $54.95 | $60.26 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $54.95 | Facility | None | $44.67 | $44.67 | $54.95 |
Cigna Setting Facility Modifier RR · Rental Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | RR · Rental | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier RR · Rental Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | RR · Rental | $109.65 | $109.65 | $109.65 |
Emblem Health Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $114.82 | Professional | None | $64.57 | $81.28 | $114.82 |
Geisinger Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Geisinger Setting Professional Modifier None Typical Low $37.15 Median $39.81 Typical High $61.66 | Professional | None | $37.15 | $39.81 | $61.66 |
Martin's Point Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Martin's Point Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $37.15 | Professional | None | $34.67 | $34.67 | $37.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.37 Typical High $5.50 | Professional | 55 · Aftercare only | $5.25 | $5.37 | $5.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $3.72 |
Martin's Point Setting Professional Modifier RR · Rental Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | RR · Rental | $3.55 | $3.55 | $3.55 |
Oscar Health Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $154.88 | Professional | None | $91.20 | $147.91 | $154.88 |
UPMC Health Plan Setting Facility Modifier None Typical Low $61.66 Median $660.69 Typical High $1,288.25 | Facility | None | $61.66 | $660.69 | $1,288.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $173.78 | Professional | None | $61.66 | $72.44 | $173.78 |
United Setting Professional Modifier None Typical Low $32.36 Median $37.15 Typical High $57.54 | Professional | None | $32.36 | $37.15 | $57.54 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | MS · Maintenance fee | $3.55 | $3.55 | $3.55 |
Martin's Point Setting Professional Modifier MS · Maintenance fee Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | MS · Maintenance fee | $3.55 | $3.55 | $3.55 |
Where Pennsylvania sits
The same service costs 2.5 times more in Wyoming than in Florida. 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· 27th of 51
$47.86
WY $93.33FL $38.02
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.