How much rates vary
Facilitymedian $126 · 10th to 90th $91 to $1,175Professionalmedian $120 · 10th to 90th $91 to $224
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 $91.20 Median $91.20 Typical High $102.33 | Facility | None | $91.20 | $91.20 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $107.15 | Professional | None | $91.20 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $51.29 Typical High $53.70 | Professional | 52 · Reduced service | $45.71 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $21.38 | Professional | 53 · Discontinued | $18.20 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $16.22 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.12 | $10.23 | $10.72 |
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 $181.97 Median $223.87 Typical High $223.87 | Professional | None | $181.97 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $1,071.52 | Professional | None | $91.20 | $91.20 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $416.87 | Professional | None | $229.09 | $363.08 | $416.87 |
Geisinger Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Geisinger Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $229.09 | Professional | None | $117.49 | $134.90 | $229.09 |
Martin's Point Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Martin's Point Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $107.15 | Professional | None | $91.20 | $102.33 | $107.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $51.29 Typical High $53.70 | Professional | 52 · Reduced service | $45.71 | $51.29 | $53.70 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $21.38 | Professional | 53 · Discontinued | $18.20 | $20.42 | $21.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $16.22 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $16.22 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.23 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.12 | $10.23 | $10.72 |
Oscar Health Setting Professional Modifier None Typical Low $151.36 Median $346.74 Typical High $371.54 | Professional | None | $151.36 | $346.74 | $371.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $158.49 Median $724.44 Typical High $1,230.27 | Facility | None | $158.49 | $724.44 | $1,230.27 |
UPMC Health Plan Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $302.00 | Facility | None | $87.10 | $100.00 | $302.00 |
United Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $173.78 | Professional | None | $83.18 | $112.20 | $173.78 |
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 $199.53 Median $223.87 Typical High $223.87 | Professional | 50 · Both sides | $199.53 | $223.87 | $223.87 |
Where Pennsylvania sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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
$120
HI $219DE $91.20
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.