How much rates vary
Facilitymedian $525 · 10th to 90th $389 to $3,548Professionalmedian $380 · 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 $323.59 | Professional | None | $275.42 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $138.04 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $60.26 | $64.57 |
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 $32.36 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $32.36 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $512.86 Median $512.86 Typical High $549.54 | Professional | None | $512.86 | $512.86 | $549.54 |
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 $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $3,548.13 | Professional | None | $380.19 | $380.19 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $1,412.54 | Professional | None | $776.25 | $1,230.27 | $1,412.54 |
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 Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Highmark BCBS Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | None | $467.74 | $501.19 | $537.03 |
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 $323.59 | Professional | None | $275.42 | $302.00 | $323.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $138.04 | $151.36 | $162.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $60.26 | $64.57 |
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 $32.36 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $32.36 |
Oscar Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $1,202.26 | Professional | None | $263.03 | $263.03 | $1,202.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $457.09 Median $2,187.76 Typical High $3,715.35 | Facility | None | $457.09 | $2,187.76 | $3,715.35 |
UPMC Health Plan Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | None | $457.09 | $457.09 | $630.96 |
United Setting Facility Modifier None Typical Low $389.05 Median $416.87 Typical High $1,023.29 | Facility | None | $389.05 | $416.87 | $1,023.29 |
United Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $549.54 | Professional | None | $263.03 | $331.13 | $549.54 |
2 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 |
|---|---|---|---|---|---|
Cigna Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | RR · Rental | $52.48 | $52.48 | $52.48 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $467.74 Median $537.03 Typical High $549.54 | Professional | KX · Policy requirements met | $467.74 | $537.03 | $549.54 |
Where Pennsylvania sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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
$380
HI $977MD $355
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.