How much rates vary
Facilitymedian $72 · 10th to 90th $48 to $617Professionalmedian $66 · 10th to 90th $48 to $117
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 $47.86 Median $47.86 Typical High $52.48 | Facility | None | $47.86 | $47.86 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | None | $47.86 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $26.30 Typical High $28.18 | Professional | 52 · Reduced service | $23.99 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.72 Typical High $11.22 | Professional | 53 · Discontinued | $9.55 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.94 Typical High $8.32 | Professional | 55 · Aftercare only | $7.24 | $7.94 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.25 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.79 | $5.25 | $5.62 |
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 $93.33 Median $117.49 Typical High $117.49 | Professional | None | $93.33 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $537.03 | Professional | None | $53.70 | $53.70 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $177.83 | Professional | None | $97.72 | $154.88 | $177.83 |
Geisinger Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Geisinger Setting Professional Modifier None Typical Low $61.66 Median $70.79 Typical High $117.49 | Professional | None | $61.66 | $70.79 | $117.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Highmark BCBS Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | None | $81.28 | $81.28 | $87.10 |
Martin's Point Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Martin's Point Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | None | $47.86 | $52.48 | $56.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $26.30 Typical High $28.18 | Professional | 52 · Reduced service | $23.99 | $26.30 | $28.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.72 Typical High $11.22 | Professional | 53 · Discontinued | $9.55 | $10.72 | $11.22 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.94 Typical High $8.32 | Professional | 55 · Aftercare only | $7.24 | $7.94 | $8.32 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.25 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.79 | $5.25 | $5.62 |
Oscar Health Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $158.49 | Professional | None | $64.57 | $109.65 | $158.49 |
UPMC Health Plan Setting Facility Modifier None Typical Low $83.18 Median $380.19 Typical High $645.65 | Facility | None | $83.18 | $380.19 | $645.65 |
UPMC Health Plan Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | None | $83.18 | $83.18 | $109.65 |
United Setting Facility Modifier None Typical Low $47.86 Median $64.57 Typical High $158.49 | Facility | None | $47.86 | $64.57 | $158.49 |
United Setting Professional Modifier None Typical Low $43.65 Median $57.54 Typical High $89.13 | Professional | None | $43.65 | $57.54 | $89.13 |
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 $104.71 Median $117.49 Typical High $117.49 | Professional | 50 · Both sides | $104.71 | $117.49 | $117.49 |
Where Pennsylvania sits
The same service costs 3.2 times more in Hawaii than in Florida. 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· 20th of 51
$70.79
HI $166FL $52.48
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.