How much rates vary
Facilitymedian $89 · 10th to 90th $72 to $562Professionalmedian $68 · 10th to 90th $46 to $112
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 $45.71 Median $45.71 Typical High $83.18 | Facility | None | $45.71 | $45.71 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $69.18 | Professional | None | $45.71 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $25.12 Typical High $26.92 | Professional | 52 · Reduced service | $22.91 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.00 Typical High $10.72 | Professional | 53 · Discontinued | $9.12 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.59 Typical High $7.94 | Professional | 55 · Aftercare only | $6.92 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.01 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.57 | $5.01 | $5.37 |
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 $89.13 Median $112.20 Typical High $112.20 | Professional | None | $89.13 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $89.13 Typical High $89.13 | Facility | None | $85.11 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $616.60 | Professional | None | $64.57 | $64.57 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $208.93 | Professional | None | $114.82 | $177.83 | $208.93 |
Geisinger Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Geisinger Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $112.20 | Professional | None | $58.88 | $67.61 | $112.20 |
Highmark BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Martin's Point Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $83.18 | Facility | None | $45.71 | $45.71 | $83.18 |
Martin's Point Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $66.07 | Professional | None | $45.71 | $50.12 | $66.07 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $25.12 Typical High $26.92 | Professional | 52 · Reduced service | $22.91 | $25.12 | $26.92 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.00 Typical High $10.72 | Professional | 53 · Discontinued | $9.12 | $10.00 | $10.72 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.59 Typical High $7.94 | Professional | 55 · Aftercare only | $6.92 | $7.59 | $7.94 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.01 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.57 | $5.01 | $5.37 |
Oscar Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $173.78 | Professional | None | $38.90 | $38.90 | $173.78 |
UPMC Health Plan Setting Facility Modifier None Typical Low $75.86 Median $363.08 Typical High $616.60 | Facility | None | $75.86 | $363.08 | $616.60 |
UPMC Health Plan Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $104.71 | Professional | None | $75.86 | $75.86 | $104.71 |
United Setting Facility Modifier None Typical Low $72.44 Median $75.86 Typical High $181.97 | Facility | None | $72.44 | $75.86 | $181.97 |
United Setting Professional Modifier None Typical Low $45.71 Median $54.95 Typical High $91.20 | Professional | None | $45.71 | $54.95 | $91.20 |
3 more rates 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 $100.00 Median $112.20 Typical High $112.20 | Professional | 50 · Both sides | $100.00 | $112.20 | $112.20 |
Cigna Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | RR · Rental | $8.91 | $8.91 | $8.91 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | KX · Policy requirements met | $83.18 | $83.18 | $87.10 |
Where Pennsylvania sits
The same service costs 2.8 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· 33rd of 51
$72.44
HI $166DC $58.88
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.