How much rates vary
Facilitymedian $813 · 10th to 90th $813 to $1,738Professionalmedian $646 · 10th to 90th $398 to $912
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 $398.11 Median $398.11 Typical High $446.68 | Facility | None | $398.11 | $398.11 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $794.33 | Professional | None | $398.11 | $446.68 | $794.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $199.53 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $93.33 | Professional | 53 · Discontinued | $79.43 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $44.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $39.81 | $44.67 | $46.77 |
AmeriHealth Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $691.83 Median $794.33 Typical High $794.33 | Professional | None | $691.83 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Facility | None | $812.83 | $812.83 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $4,168.69 | Professional | None | $588.84 | $588.84 | $4,168.69 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $1,348.96 | Professional | None | $741.31 | $1,174.90 | $1,348.96 |
Geisinger Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Geisinger Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $812.83 | Professional | None | $489.78 | $562.34 | $812.83 |
Highmark BCBS Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $891.25 | Professional | None | $549.54 | $588.84 | $891.25 |
Independence Blue Cross Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Martin's Point Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Martin's Point Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $794.33 | Professional | None | $398.11 | $446.68 | $794.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $199.53 | $218.78 | $234.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $93.33 | Professional | 53 · Discontinued | $79.43 | $89.13 | $93.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $70.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $44.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $39.81 | $44.67 | $46.77 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $812.83 | Professional | None | $489.78 | $501.19 | $812.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $870.96 Median $912.01 Typical High $912.01 | Facility | None | $870.96 | $912.01 | $912.01 |
UPMC Health Plan Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | None | $870.96 | $912.01 | $912.01 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,737.80 | Facility | None | $1,445.44 | $1,445.44 | $1,737.80 |
United Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $1,047.13 | Professional | None | $489.78 | $630.96 | $1,047.13 |
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 $81.28 Median $81.28 Typical High $81.28 | Facility | RR · Rental | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | RR · Rental | $69.18 | $69.18 | $81.28 |
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· 38th of 51
$676
HI $1,445UT $550
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.