How much rates vary
Facilitymedian $219 · 10th to 90th $200 to $1,622Professionalmedian $166 · 10th to 90th $126 to $309
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 $125.89 Median $125.89 Typical High $141.25 | Facility | None | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $147.91 | Professional | None | $125.89 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $70.79 Typical High $74.13 | Professional | 52 · Reduced service | $63.10 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.18 Typical High $29.51 | Professional | 53 · Discontinued | $25.12 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.13 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.59 | $14.13 | $14.79 |
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 $251.19 Median $309.03 Typical High $309.03 | Professional | None | $251.19 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $1,698.24 | Professional | None | $158.49 | $158.49 | $1,698.24 |
Emblem Health Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $645.65 | Professional | None | $354.81 | $549.54 | $645.65 |
Geisinger Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Geisinger Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $316.23 | Professional | None | $162.18 | $186.21 | $316.23 |
Martin's Point Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $147.91 | Professional | None | $125.89 | $141.25 | $147.91 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $70.79 Typical High $74.13 | Professional | 52 · Reduced service | $63.10 | $70.79 | $74.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.18 Typical High $29.51 | Professional | 53 · Discontinued | $25.12 | $28.18 | $29.51 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $22.39 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.13 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.59 | $14.13 | $14.79 |
Oscar Health Setting Professional Modifier None Typical Low $234.42 Median $389.05 Typical High $562.34 | Professional | None | $234.42 | $389.05 | $562.34 |
UPMC Health Plan Setting Facility Modifier None Typical Low $218.78 Median $1,000.00 Typical High $1,698.24 | Facility | None | $218.78 | $1,000.00 | $1,698.24 |
UPMC Health Plan Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | None | $218.78 | $218.78 | $295.12 |
United Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $489.78 | Facility | None | $199.53 | $204.17 | $489.78 |
United Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $257.04 | Professional | None | $125.89 | $154.88 | $257.04 |
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 $275.42 Median $309.03 Typical High $309.03 | Professional | 50 · Both sides | $275.42 | $309.03 | $309.03 |
Where Pennsylvania sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 31st of 51
$186
HI $525WV $158
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.