How much rates vary
Facilitymedian $468 · 10th to 90th $417 to $3,715Professionalmedian $316 · 10th to 90th $275 to $631
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 $302.00 | Facility | None | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $338.84 | Professional | None | $275.42 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $134.90 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $47.86 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $31.62 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $31.62 |
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 $501.19 Median $501.19 Typical High $537.03 | Professional | None | $501.19 | $501.19 | $537.03 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 50 · Both sides | $602.56 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $3,311.31 | Professional | None | $309.03 | $309.03 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $977.24 Typical High $1,122.02 | Professional | None | $616.60 | $977.24 | $1,122.02 |
Geisinger Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Geisinger Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $676.08 | Professional | None | $354.81 | $407.38 | $676.08 |
Highmark BCBS Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $707.95 | Professional | None | $467.74 | $467.74 | $707.95 |
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 $302.00 Typical High $316.23 | Professional | None | $275.42 | $302.00 | $316.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $134.90 | $151.36 | $158.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $60.26 | $63.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $47.86 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $47.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $31.62 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $31.62 |
Oscar Health Setting Professional Modifier None Typical Low $257.04 Median $602.56 Typical High $954.99 | Professional | None | $257.04 | $602.56 | $954.99 |
UPMC Health Plan Setting Facility Modifier None Typical Low $467.74 Median $2,137.96 Typical High $3,715.35 | Facility | None | $467.74 | $2,137.96 | $3,715.35 |
UPMC Health Plan Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
United Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $977.24 | Facility | None | $831.76 | $831.76 | $977.24 |
United Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $501.19 | Professional | None | $257.04 | $331.13 | $501.19 |
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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $467.74 Median $537.03 Typical High $537.03 | Professional | KX · Policy requirements met | $467.74 | $537.03 | $537.03 |
Where Pennsylvania sits
The same service costs 2.2 times more in Montana 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· 49th of 51
$331
MT $692DE $309
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.