How much rates vary
Facilitymedian $87 · 10th to 90th $66 to $851Professionalmedian $85 · 10th to 90th $63 to $158
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 $66.07 Median $66.07 Typical High $72.44 | Facility | None | $66.07 | $66.07 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $75.86 | Professional | None | $66.07 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $36.31 Typical High $38.02 | Professional | 52 · Reduced service | $32.36 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.45 Typical High $15.14 | Professional | 53 · Discontinued | $13.18 | $14.45 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.96 Typical High $11.48 | Professional | 55 · Aftercare only | $9.77 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.24 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.61 | $7.24 | $7.59 |
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 $128.82 Median $158.49 Typical High $158.49 | Professional | None | $128.82 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $741.31 | Professional | None | $63.10 | $63.10 | $741.31 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $295.12 | Professional | None | $162.18 | $257.04 | $295.12 |
Geisinger Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Geisinger Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $162.18 | Professional | None | $83.18 | $97.72 | $162.18 |
Martin's Point Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Martin's Point Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $75.86 | Professional | None | $66.07 | $72.44 | $75.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $36.31 Typical High $38.02 | Professional | 52 · Reduced service | $32.36 | $36.31 | $38.02 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.45 Typical High $15.14 | Professional | 53 · Discontinued | $13.18 | $14.45 | $15.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.96 Typical High $11.48 | Professional | 55 · Aftercare only | $9.77 | $10.96 | $11.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.24 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.61 | $7.24 | $7.59 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $263.03 | Professional | None | $107.15 | $181.97 | $263.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $114.82 Median $512.86 Typical High $891.25 | Facility | None | $114.82 | $512.86 | $891.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | None | $114.82 | $114.82 | $151.36 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $223.87 | Facility | None | $39.81 | $69.18 | $223.87 |
United Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $128.82 | Professional | None | $61.66 | $79.43 | $128.82 |
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 $144.54 Median $158.49 Typical High $158.49 | Professional | 50 · Both sides | $144.54 | $158.49 | $158.49 |
Where Pennsylvania sits
The same service costs 2.5 times more in Arkansas 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
$87.10
AR $158FL $64.57
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.