How much rates vary
Facilitymedian $66 · 10th to 90th $48 to $501Professionalmedian $50 · 10th to 90th $39 to $93
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 $38.90 Median $38.90 Typical High $42.66 | Facility | None | $38.90 | $38.90 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $44.67 | Professional | None | $38.90 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $21.38 Typical High $22.39 | Professional | 52 · Reduced service | $19.50 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.51 Typical High $9.12 | Professional | 53 · Discontinued | $7.76 | $8.51 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.46 Typical High $6.76 | Professional | 55 · Aftercare only | $5.75 | $6.46 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.27 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.89 | $4.27 | $4.47 |
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 $75.86 Median $93.33 Typical High $93.33 | Professional | None | $75.86 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $489.78 | Professional | None | $48.98 | $48.98 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $151.36 | Professional | None | $83.18 | $128.82 | $151.36 |
Geisinger Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Geisinger Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $95.50 | Professional | None | $50.12 | $57.54 | $95.50 |
Martin's Point Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Martin's Point Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $44.67 | Professional | None | $38.90 | $42.66 | $44.67 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $21.38 Typical High $22.39 | Professional | 52 · Reduced service | $19.50 | $21.38 | $22.39 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.51 Typical High $9.12 | Professional | 53 · Discontinued | $7.76 | $8.51 | $9.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.46 Typical High $6.76 | Professional | 55 · Aftercare only | $5.75 | $6.46 | $6.76 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.27 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.89 | $4.27 | $4.47 |
Oscar Health Setting Professional Modifier None Typical Low $53.70 Median $91.20 Typical High $131.83 | Professional | None | $53.70 | $91.20 | $131.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $67.61 Median $302.00 Typical High $524.81 | Facility | None | $67.61 | $302.00 | $524.81 |
UPMC Health Plan Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $89.13 | Professional | None | $67.61 | $67.61 | $89.13 |
United Setting Facility Modifier None Typical Low $47.86 Median $58.88 Typical High $144.54 | Facility | None | $47.86 | $58.88 | $144.54 |
United Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $77.62 | Professional | None | $36.31 | $46.77 | $77.62 |
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 $85.11 Median $93.33 Typical High $93.33 | Professional | 50 · Both sides | $85.11 | $93.33 | $93.33 |
Where Pennsylvania sits
The same service costs 3.4 times more in Hawaii than in Vermont. 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
$57.54
HI $166VT $48.98
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.