How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Ambetter Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
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 $60.26 Median $60.26 Typical High $63.10 | Professional | None | $60.26 | $60.26 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | None | $0.68 | $0.68 | $0.68 |
Geisinger Setting Professional Modifier None Typical Low $18.62 Median $25.12 Typical High $28.84 | Professional | None | $18.62 | $25.12 | $28.84 |
Martin's Point Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
4 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 $1.05 Median $1.05 Typical High $1.05 | Professional | 52 · Reduced service | $1.05 | $1.05 | $1.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 53 · Discontinued | $0.42 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.21 |
Where Pennsylvania sits
The same service costs 398.1 times more in Nebraska than in Washington, DC. 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· 5th of 51
$60.26
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.