How much rates vary
Facilitymedian $316 · 10th to 90th $245 to $2,188Professionalmedian $263 · 10th to 90th $178 to $427
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 $177.83 Median $177.83 Typical High $194.98 | Facility | None | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $275.42 | Professional | None | $177.83 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $89.13 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.90 Typical High $41.69 | Professional | 53 · Discontinued | $35.48 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $29.51 Typical High $30.90 | Professional | 55 · Aftercare only | $26.30 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.50 Typical High $20.89 | Professional | 56 · Pre-op care only | $17.78 | $19.50 | $20.89 |
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 $346.74 Median $426.58 Typical High $426.58 | Professional | None | $346.74 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $2,344.23 | Professional | None | $229.09 | $229.09 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $776.25 | Professional | None | $426.58 | $676.08 | $776.25 |
Geisinger Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Geisinger Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $436.52 | Professional | None | $229.09 | $263.03 | $436.52 |
Highmark BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $346.74 | Professional | None | $323.59 | $323.59 | $346.74 |
Martin's Point Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Martin's Point Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $275.42 | Professional | None | $177.83 | $194.98 | $275.42 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $89.13 | $97.72 | $102.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.90 Typical High $41.69 | Professional | 53 · Discontinued | $35.48 | $38.90 | $41.69 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $29.51 Typical High $30.90 | Professional | 55 · Aftercare only | $26.30 | $29.51 | $30.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.50 Typical High $20.89 | Professional | 56 · Pre-op care only | $17.78 | $19.50 | $20.89 |
Oscar Health Setting Professional Modifier None Typical Low $281.84 Median $645.65 Typical High $691.83 | Professional | None | $281.84 | $645.65 | $691.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $2,398.83 | Facility | None | $309.03 | $1,380.38 | $2,398.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $407.38 | Professional | None | $309.03 | $309.03 | $407.38 |
United Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $676.08 | Facility | None | $245.47 | $269.15 | $676.08 |
United Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $354.81 | Professional | None | $173.78 | $213.80 | $354.81 |
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 $389.05 Median $426.58 Typical High $426.58 | Professional | 50 · Both sides | $389.05 | $426.58 | $426.58 |
Where Pennsylvania sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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
$269
HI $589AZ $229
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.