How much rates vary
Facilitymedian $178 · 10th to 90th $148 to $5,012Professionalmedian $148 · 10th to 90th $112 to $257
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 $141.25 Median $147.91 Typical High $147.91 | Facility | None | $141.25 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $147.91 | Professional | None | $131.83 | $141.25 | $147.91 |
Aetna Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $104.71 Typical High $112.20 | Professional | UE · Used equipment | $83.18 | $104.71 | $112.20 |
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 $23.99 Median $204.17 Typical High $239.88 | Professional | None | $23.99 | $204.17 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier RR · Rental Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | RR · Rental | $17.78 | $17.78 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | None | $151.36 | $151.36 | $177.83 |
Cigna Setting Professional Modifier RR · Rental Typical Low $15.14 Median $15.14 Typical High $17.78 | Professional | RR · Rental | $15.14 | $15.14 | $17.78 |
Cigna Setting Professional Modifier UE · Used equipment Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | UE · Used equipment | $114.82 | $114.82 | $114.82 |
Emblem Health Setting Professional Modifier RR · Rental Typical Low $22.91 Median $22.91 Typical High $25.12 | Professional | RR · Rental | $22.91 | $22.91 | $25.12 |
Geisinger Setting Facility Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | RR · Rental | $25.12 | $25.12 | $25.12 |
Geisinger Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $144.54 | Professional | None | $117.49 | $117.49 | $144.54 |
Geisinger Setting Professional Modifier RR · Rental Typical Low $14.79 Median $17.38 Typical High $25.12 | Professional | RR · Rental | $14.79 | $17.38 | $25.12 |
Geisinger Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $107.15 | Professional | UE · Used equipment | $87.10 | $87.10 | $107.15 |
Highmark BCBS Setting Professional Modifier RR · Rental Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | RR · Rental | $20.89 | $20.89 | $20.89 |
Martin's Point Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Martin's Point Setting Professional Modifier None Typical Low $138.04 Median $141.25 Typical High $147.91 | Professional | None | $138.04 | $141.25 | $147.91 |
Martin's Point Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | UE · Used equipment | $95.50 | $104.71 | $112.20 |
UPMC Health Plan Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
UPMC Health Plan Setting Facility Modifier RR · Rental Typical Low $19.50 Median $114.82 Typical High $199.53 | Facility | RR · Rental | $19.50 | $114.82 | $199.53 |
UPMC Health Plan Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
UPMC Health Plan Setting Professional Modifier RR · Rental Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | RR · Rental | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $245.47 | Professional | None | $102.33 | $120.23 | $245.47 |
United Setting Professional Modifier RR · Rental Typical Low $13.18 Median $15.85 Typical High $27.54 | Professional | RR · Rental | $13.18 | $15.85 | $27.54 |
United Setting Professional Modifier UE · Used equipment Typical Low $77.62 Median $89.13 Typical High $186.21 | Professional | UE · Used equipment | $77.62 | $89.13 | $186.21 |
10 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 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | 52 · Reduced service | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 53 · Discontinued | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.79 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | 52 · Reduced service | $70.79 | $70.79 | $74.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 53 · Discontinued | $28.18 | $28.18 | $29.51 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $22.39 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.79 |
UPMC Health Plan Setting Facility Modifier LL · Lease toward purchase Typical Low $15.14 Median $74.13 Typical High $117.49 | Facility | LL · Lease toward purchase | $15.14 | $74.13 | $117.49 |
UPMC Health Plan Setting Professional Modifier LL · Lease toward purchase Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | LL · Lease toward purchase | $15.14 | $15.14 | $15.14 |
Where Pennsylvania sits
The same service costs 22.4 times more in Kansas than in Illinois. 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· 41st of 51
$151
KS $447IL $19.95
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.