How much rates vary
Facilitymedian $28 · 10th to 90th $20 to $166Professionalmedian $18 · 10th to 90th $13 to $32
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 $12.88 Median $12.88 Typical High $14.45 | Facility | None | $12.88 | $12.88 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $14.45 Typical High $19.95 | Professional | None | $12.88 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.46 Median $7.24 Typical High $7.59 | Professional | 52 · Reduced service | $6.46 | $7.24 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.88 Typical High $3.02 | Professional | 53 · Discontinued | $2.57 | $2.88 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.14 Typical High $2.29 | Professional | 55 · Aftercare only | $1.95 | $2.14 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.45 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.29 | $1.45 | $1.51 |
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 $25.70 Median $31.62 Typical High $31.62 | Professional | None | $25.70 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $31.62 | Facility | None | $22.39 | $22.39 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $169.82 | Professional | None | $16.22 | $16.22 | $169.82 |
Emblem Health Setting Professional Modifier None Typical Low $28.18 Median $44.67 Typical High $51.29 | Professional | None | $28.18 | $44.67 | $51.29 |
Geisinger Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Geisinger Setting Professional Modifier None Typical Low $16.22 Median $19.50 Typical High $32.36 | Professional | None | $16.22 | $19.50 | $32.36 |
Highmark BCBS Setting Facility Modifier None Typical Low $4.27 Median $15.14 Typical High $186.21 | Facility | None | $4.27 | $15.14 | $186.21 |
Highmark BCBS Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Martin's Point Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Martin's Point Setting Professional Modifier None Typical Low $12.88 Median $14.45 Typical High $19.95 | Professional | None | $12.88 | $14.45 | $19.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.46 Median $7.24 Typical High $7.59 | Professional | 52 · Reduced service | $6.46 | $7.24 | $7.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.88 Typical High $3.02 | Professional | 53 · Discontinued | $2.57 | $2.88 | $3.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.14 Typical High $2.29 | Professional | 55 · Aftercare only | $1.95 | $2.14 | $2.29 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.45 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.29 | $1.45 | $1.51 |
Oscar Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $42.66 | Professional | None | $10.00 | $10.00 | $42.66 |
UPMC Health Plan Setting Facility Modifier None Typical Low $20.89 Median $102.33 Typical High $177.83 | Facility | None | $20.89 | $102.33 | $177.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $30.20 | Professional | None | $20.89 | $20.89 | $30.20 |
United Setting Facility Modifier None Typical Low $19.95 Median $28.18 Typical High $48.98 | Facility | None | $19.95 | $28.18 | $48.98 |
United Setting Professional Modifier None Typical Low $12.30 Median $15.85 Typical High $26.30 | Professional | None | $12.30 | $15.85 | $26.30 |
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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $28.18 Median $31.62 Typical High $31.62 | Professional | 50 · Both sides | $28.18 | $31.62 | $31.62 |
Where Pennsylvania sits
The same service costs 3.7 times more in Hawaii 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· 26th of 51
$19.50
HI $60.26FL $16.22
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.