How much rates vary
Facilitymedian $550 · 10th to 90th $407 to $4,266Professionalmedian $398 · 10th to 90th $331 to $759
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 $331.13 Median $363.08 Typical High $602.56 | Facility | None | $331.13 | $363.08 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $457.09 | Professional | None | $331.13 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $75.86 | Professional | 53 · Discontinued | $66.07 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $38.02 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
AmeriHealth Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $602.56 Median $630.96 Typical High $724.44 | Professional | None | $602.56 | $630.96 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $3,981.07 | Professional | None | $338.84 | $338.84 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $1,548.82 | Professional | None | $851.14 | $1,348.96 | $1,548.82 |
Geisinger Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Geisinger Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $812.83 | Professional | None | $416.87 | $489.78 | $812.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $91.20 Median $1,905.46 Typical High $3,630.78 | Facility | None | $91.20 | $1,905.46 | $3,630.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | None | $562.34 | $645.65 | $645.65 |
Independence Blue Cross Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Martin's Point Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $602.56 | Facility | None | $331.13 | $331.13 | $602.56 |
Martin's Point Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $457.09 | Professional | None | $331.13 | $363.08 | $457.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $181.97 | $190.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $75.86 | Professional | 53 · Discontinued | $66.07 | $72.44 | $75.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $57.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $38.02 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $302.00 Typical High $1,318.26 | Professional | None | $50.12 | $302.00 | $1,318.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $549.54 Median $2,570.40 Typical High $4,466.84 | Facility | None | $549.54 | $2,570.40 | $4,466.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
United Setting Facility Modifier None Typical Low $407.38 Median $933.25 Typical High $1,122.02 | Facility | None | $407.38 | $933.25 | $1,122.02 |
United Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $630.96 | Professional | None | $309.03 | $398.11 | $630.96 |
2 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 $724.44 Median $794.33 Typical High $794.33 | Professional | 50 · Both sides | $724.44 | $794.33 | $794.33 |
Cigna Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | RR · Rental | $45.71 | $45.71 | $45.71 |
Where Pennsylvania sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 45th of 51
$398
HI $871NH $339
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.