How much rates vary
Facilitymedian $58 · 10th to 90th $44 to $537Professionalmedian $52 · 10th to 90th $43 to $100
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 $43.65 Median $43.65 Typical High $436.52 | Facility | None | $43.65 | $43.65 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $61.66 | Professional | None | $43.65 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $23.99 Typical High $25.12 | Professional | 52 · Reduced service | $21.38 | $23.99 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.55 Typical High $10.00 | Professional | 53 · Discontinued | $8.71 | $9.55 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.24 Typical High $7.59 | Professional | 55 · Aftercare only | $6.46 | $7.24 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.79 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.37 | $4.79 | $5.01 |
Ambetter Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $151.36 | Professional | None | $51.29 | $79.43 | $151.36 |
AmeriHealth Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $79.43 | Professional | None | $61.66 | $67.61 | $79.43 |
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 $79.43 Median $79.43 Typical High $85.11 | Professional | None | $79.43 | $79.43 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $501.19 | Professional | None | $42.66 | $42.66 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $199.53 | Professional | None | $109.65 | $173.78 | $199.53 |
Geisinger Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Geisinger Setting Professional Modifier None Typical Low $56.23 Median $64.57 Typical High $107.15 | Professional | None | $56.23 | $64.57 | $107.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $51.29 Median $257.04 Typical High $426.58 | Facility | None | $51.29 | $257.04 | $426.58 |
Highmark BCBS Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $104.71 | Professional | None | $74.13 | $85.11 | $104.71 |
Independence Blue Cross Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $79.43 | Professional | None | $61.66 | $61.66 | $79.43 |
Martin's Point Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $436.52 | Facility | None | $43.65 | $43.65 | $436.52 |
Martin's Point Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $58.88 | Professional | None | $43.65 | $47.86 | $58.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $23.99 Typical High $25.12 | Professional | 52 · Reduced service | $21.38 | $23.99 | $25.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.55 Typical High $10.00 | Professional | 53 · Discontinued | $8.71 | $9.55 | $10.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.24 Typical High $7.59 | Professional | 55 · Aftercare only | $6.46 | $7.24 | $7.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.79 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.37 | $4.79 | $5.01 |
Oscar Health Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $169.82 | Professional | None | $37.15 | $53.70 | $169.82 |
UPMC Health Plan Setting Facility Modifier None Typical Low $72.44 Median $338.84 Typical High $588.84 | Facility | None | $72.44 | $338.84 | $588.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
United Setting Facility Modifier None Typical Low $43.65 Median $51.29 Typical High $147.91 | Facility | None | $43.65 | $51.29 | $147.91 |
United Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $83.18 | Professional | None | $40.74 | $52.48 | $83.18 |
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 $95.50 Median $104.71 Typical High $104.71 | Professional | 50 · Both sides | $95.50 | $104.71 | $104.71 |
Cigna Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $5.75 | $5.75 | $5.75 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $74.13 Median $79.43 Typical High $85.11 | Professional | KX · Policy requirements met | $74.13 | $79.43 | $85.11 |
Where Pennsylvania sits
The same service costs 2.6 times more in Hawaii 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· 43rd of 51
$53.70
HI $117DE $44.67
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.