How much rates vary
Facilitymedian $224 · 10th to 90th $191 to $1,514Professionalmedian $166 · 10th to 90th $117 to $288
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 $117.49 Median $117.49 Typical High $131.83 | Facility | None | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $138.04 | Professional | None | $117.49 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $66.07 Typical High $69.18 | Professional | 52 · Reduced service | $58.88 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.30 Typical High $27.54 | Professional | 53 · Discontinued | $23.44 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $20.89 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.18 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.75 | $13.18 | $13.80 |
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 $234.42 Median $288.40 Typical High $288.40 | Professional | None | $234.42 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $1,621.81 | Professional | None | $165.96 | $165.96 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $489.78 | Professional | None | $269.15 | $426.58 | $489.78 |
Geisinger Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Geisinger Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $295.12 | Professional | None | $151.36 | $177.83 | $295.12 |
Martin's Point Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Martin's Point Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $138.04 | Professional | None | $117.49 | $131.83 | $138.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $66.07 Typical High $69.18 | Professional | 52 · Reduced service | $58.88 | $66.07 | $69.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.30 Typical High $27.54 | Professional | 53 · Discontinued | $23.44 | $26.30 | $27.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $20.89 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $20.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.18 Typical High $13.80 | Professional | 56 · Pre-op care only | $11.75 | $13.18 | $13.80 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $407.38 Typical High $436.52 | Professional | None | $177.83 | $407.38 | $436.52 |
UPMC Health Plan Setting Facility Modifier None Typical Low $204.17 Median $933.25 Typical High $1,621.81 | Facility | None | $204.17 | $933.25 | $1,621.81 |
UPMC Health Plan Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
United Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $467.74 | Facility | None | $190.55 | $208.93 | $467.74 |
United Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $239.88 | Professional | None | $120.23 | $144.54 | $239.88 |
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 $257.04 Median $288.40 Typical High $288.40 | Professional | 50 · Both sides | $257.04 | $288.40 | $288.40 |
Where Pennsylvania sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 30th of 51
$178
HI $525DC $155
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.