How much rates vary
Facilitymedian $741 · 10th to 90th $646 to $5,012Professionalmedian $631 · 10th to 90th $479 to $1,175
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 $478.63 Median $478.63 Typical High $524.81 | Facility | None | $478.63 | $478.63 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $562.34 | Professional | None | $478.63 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $107.15 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $56.23 |
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 $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | None | $954.99 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $5,754.40 | Professional | None | $537.03 | $537.03 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,737.80 | $1,995.26 |
Geisinger Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Geisinger Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,174.90 | Professional | None | $616.60 | $707.95 | $1,174.90 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $562.34 | Professional | None | $478.63 | $524.81 | $562.34 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $263.03 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $107.15 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $107.15 | $112.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $85.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $56.23 |
Oscar Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,659.59 | Professional | None | $467.74 | $467.74 | $1,659.59 |
UPMC Health Plan Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $6,456.54 | Facility | None | $831.76 | $3,801.89 | $6,456.54 |
UPMC Health Plan Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,096.48 | Professional | None | $831.76 | $831.76 | $1,096.48 |
United Setting Facility Modifier None Typical Low $645.65 Median $691.83 Typical High $1,698.24 | Facility | None | $645.65 | $691.83 | $1,698.24 |
United Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $954.99 | Professional | None | $457.09 | $575.44 | $954.99 |
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 $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 50 · Both sides | $1,047.13 | $1,174.90 | $1,174.90 |
Where Pennsylvania sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 34th of 51
$661
HI $1,622VT $537
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.