How much rates vary
Facilitymedian $41 · 10th to 90th $36 to $398Professionalmedian $40 · 10th to 90th $30 to $74
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 $30.90 Median $30.90 Typical High $33.88 | Facility | None | $30.90 | $30.90 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $33.88 Typical High $35.48 | Professional | None | $30.90 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $16.98 Typical High $17.78 | Professional | 52 · Reduced service | $15.49 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.76 Typical High $7.24 | Professional | 53 · Discontinued | $6.17 | $6.76 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.13 Typical High $5.37 | Professional | 55 · Aftercare only | $4.57 | $5.13 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.39 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.09 | $3.39 | $3.63 |
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 $60.26 Median $74.13 Typical High $74.13 | Professional | None | $60.26 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $346.74 | Professional | None | $29.51 | $29.51 | $346.74 |
Emblem Health Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $107.15 | Professional | None | $58.88 | $91.20 | $107.15 |
Geisinger Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Geisinger Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $75.86 | Professional | None | $38.90 | $45.71 | $75.86 |
Martin's Point Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier None Typical Low $30.90 Median $33.88 Typical High $35.48 | Professional | None | $30.90 | $33.88 | $35.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $16.98 Typical High $17.78 | Professional | 52 · Reduced service | $15.49 | $16.98 | $17.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.76 Typical High $7.24 | Professional | 53 · Discontinued | $6.17 | $6.76 | $7.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.13 Typical High $5.37 | Professional | 55 · Aftercare only | $4.57 | $5.13 | $5.37 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.39 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.09 | $3.39 | $3.63 |
Oscar Health Setting Professional Modifier None Typical Low $38.90 Median $89.13 Typical High $93.33 | Professional | None | $38.90 | $89.13 | $93.33 |
UPMC Health Plan Setting Facility Modifier None Typical Low $53.70 Median $239.88 Typical High $416.87 | Facility | None | $53.70 | $239.88 | $416.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $70.79 | Professional | None | $53.70 | $53.70 | $70.79 |
United Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $102.33 | Facility | None | $36.31 | $40.74 | $102.33 |
United Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $57.54 | Professional | None | $28.18 | $37.15 | $57.54 |
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 $67.61 Median $74.13 Typical High $74.13 | Professional | 50 · Both sides | $67.61 | $74.13 | $74.13 |
Where Pennsylvania sits
The same service costs 2.7 times more in Montana than in Delaware. 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· 22nd of 51
$40.74
MT $83.18DE $30.90
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.