How much rates vary
Facilitymedian $13 · 10th to 90th $10 to $138Professionalmedian $13 · 10th to 90th $10 to $26
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 $10.72 Median $10.72 Typical High $11.75 | Facility | None | $10.72 | $10.72 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $11.75 Typical High $12.59 | Professional | None | $10.72 | $11.75 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.37 Median $5.89 Typical High $6.31 | Professional | 52 · Reduced service | $5.37 | $5.89 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.34 Typical High $2.51 | Professional | 53 · Discontinued | $2.14 | $2.34 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.78 Typical High $1.86 | Professional | 55 · Aftercare only | $1.58 | $1.78 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.17 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.07 | $1.17 | $1.26 |
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 $21.38 Median $25.70 Typical High $25.70 | Professional | None | $21.38 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $14.13 | Facility | None | $13.49 | $13.49 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $107.15 | Professional | None | $9.77 | $9.77 | $107.15 |
Emblem Health Setting Professional Modifier None Typical Low $18.62 Median $28.84 Typical High $33.88 | Professional | None | $18.62 | $28.84 | $33.88 |
Geisinger Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Geisinger Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $26.30 | Professional | None | $14.13 | $15.85 | $26.30 |
Martin's Point Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Martin's Point Setting Professional Modifier None Typical Low $10.72 Median $11.75 Typical High $12.59 | Professional | None | $10.72 | $11.75 | $12.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $5.37 Median $5.89 Typical High $6.31 | Professional | 52 · Reduced service | $5.37 | $5.89 | $6.31 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.34 Typical High $2.51 | Professional | 53 · Discontinued | $2.14 | $2.34 | $2.51 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.78 Typical High $1.86 | Professional | 55 · Aftercare only | $1.58 | $1.78 | $1.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.17 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.07 | $1.17 | $1.26 |
Oscar Health Setting Professional Modifier None Typical Low $12.02 Median $28.18 Typical High $29.51 | Professional | None | $12.02 | $28.18 | $29.51 |
UPMC Health Plan Setting Facility Modifier None Typical Low $18.62 Median $85.11 Typical High $144.54 | Facility | None | $18.62 | $85.11 | $144.54 |
UPMC Health Plan Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $24.55 | Professional | None | $18.62 | $18.62 | $24.55 |
United Setting Facility Modifier None Typical Low $7.94 Median $9.77 Typical High $32.36 | Facility | None | $7.94 | $9.77 | $32.36 |
United Setting Professional Modifier None Typical Low $8.91 Median $12.88 Typical High $19.50 | Professional | None | $8.91 | $12.88 | $19.50 |
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 $23.44 Median $25.70 Typical High $25.70 | Professional | 50 · Both sides | $23.44 | $25.70 | $25.70 |
Where Pennsylvania sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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· 24th of 51
$13.49
AR $22.91KS $9.12
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.