How much rates vary
Facilitymedian $302 · 10th to 90th $282 to $1,023Professionalmedian $245 · 10th to 90th $145 to $355
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 $144.54 Median $144.54 Typical High $158.49 | Facility | None | $144.54 | $144.54 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $239.88 | Professional | None | $144.54 | $158.49 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $79.43 Typical High $83.18 | Professional | 52 · Reduced service | $70.79 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $31.62 Typical High $33.11 | Professional | 53 · Discontinued | $28.84 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.99 Typical High $25.12 | Professional | 55 · Aftercare only | $21.38 | $23.99 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.85 Typical High $16.60 | Professional | 56 · Pre-op care only | $14.45 | $15.85 | $16.60 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $245.47 Median $275.42 Typical High $275.42 | Professional | None | $245.47 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $1,445.44 | Professional | None | $218.78 | $218.78 | $1,445.44 |
Emblem Health Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $467.74 | Professional | None | $257.04 | $407.38 | $467.74 |
Geisinger Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Geisinger Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $281.84 | Professional | None | $169.82 | $194.98 | $281.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $269.15 | Professional | None | $190.55 | $257.04 | $269.15 |
Martin's Point Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $239.88 | Professional | None | $144.54 | $158.49 | $239.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $79.43 Typical High $83.18 | Professional | 52 · Reduced service | $70.79 | $79.43 | $83.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $31.62 Typical High $33.11 | Professional | 53 · Discontinued | $28.84 | $31.62 | $33.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.99 Typical High $25.12 | Professional | 55 · Aftercare only | $21.38 | $23.99 | $25.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.85 Typical High $16.60 | Professional | 56 · Pre-op care only | $14.45 | $15.85 | $16.60 |
Oscar Health Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $407.38 | Professional | None | $190.55 | $275.42 | $407.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $316.23 Median $354.81 Typical High $354.81 | Facility | None | $316.23 | $354.81 | $354.81 |
UPMC Health Plan Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | None | $316.23 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $588.84 | Facility | None | $489.78 | $489.78 | $588.84 |
United Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $380.19 | Professional | None | $173.78 | $239.88 | $380.19 |
2 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 |
|---|---|---|---|---|---|
Cigna Setting Facility Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | RR · Rental | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Where Pennsylvania sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 37th of 51
$245
HI $490UT $191
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.