How much rates vary
Facilitymedian $479 · 10th to 90th $389 to $3,802Professionalmedian $389 · 10th to 90th $275 to $676
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 $275.42 Median $275.42 Typical High $309.03 | Facility | None | $275.42 | $275.42 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $323.59 | Professional | None | $275.42 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $138.04 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.90 Typical High $32.36 | Professional | 56 · Pre-op care only | $27.54 | $30.90 | $32.36 |
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 $537.03 Median $676.08 Typical High $676.08 | Professional | None | $537.03 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $3,388.44 | Professional | None | $281.84 | $281.84 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,148.15 | Professional | None | $630.96 | $1,000.00 | $1,148.15 |
Geisinger Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Geisinger Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $691.83 | Professional | None | $354.81 | $416.87 | $691.83 |
Martin's Point Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Martin's Point Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $323.59 | Professional | None | $275.42 | $309.03 | $323.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $138.04 | $154.88 | $162.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $61.66 | $64.57 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $48.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.90 Typical High $32.36 | Professional | 56 · Pre-op care only | $27.54 | $30.90 | $32.36 |
Oscar Health Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,023.29 | Professional | None | $616.60 | $954.99 | $1,023.29 |
UPMC Health Plan Setting Facility Modifier None Typical Low $478.63 Median $2,187.76 Typical High $3,801.89 | Facility | None | $478.63 | $2,187.76 | $3,801.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $645.65 | Professional | None | $478.63 | $478.63 | $645.65 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Facility | None | $851.14 | $851.14 | $1,000.00 |
United Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $562.34 | Professional | None | $263.03 | $338.84 | $562.34 |
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 $616.60 Median $676.08 Typical High $676.08 | Professional | 50 · Both sides | $616.60 | $676.08 | $676.08 |
Where Pennsylvania sits
The same service costs 2.5 times more in Iowa than in Delaware. 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· 26th of 51
$389
IA $708DE $282
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.