How much rates vary
Facilitymedian $148 · 10th to 90th $102 to $1,096Professionalmedian $126 · 10th to 90th $85 to $204
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 $85.11 Median $85.11 Typical High $93.33 | Facility | None | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $100.00 | Professional | None | $85.11 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $46.77 Typical High $50.12 | Professional | 52 · Reduced service | $42.66 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $19.95 | Professional | 53 · Discontinued | $16.98 | $18.62 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $14.79 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $10.00 |
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 $165.96 Median $204.17 Typical High $204.17 | Professional | None | $165.96 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $1,023.29 | Professional | None | $107.15 | $107.15 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $354.81 | Professional | None | $194.98 | $309.03 | $354.81 |
Geisinger Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Geisinger Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $208.93 | Professional | None | $109.65 | $125.89 | $208.93 |
Martin's Point Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $100.00 | Professional | None | $85.11 | $93.33 | $100.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $46.77 Typical High $50.12 | Professional | 52 · Reduced service | $42.66 | $46.77 | $50.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $19.95 | Professional | 53 · Discontinued | $16.98 | $18.62 | $19.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $14.79 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $14.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $10.00 |
Oscar Health Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $316.23 | Professional | None | $190.55 | $295.12 | $316.23 |
UPMC Health Plan Setting Facility Modifier None Typical Low $147.91 Median $676.08 Typical High $1,148.15 | Facility | None | $147.91 | $676.08 | $1,148.15 |
UPMC Health Plan Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | None | $147.91 | $147.91 | $194.98 |
United Setting Facility Modifier None Typical Low $102.33 Median $257.04 Typical High $309.03 | Facility | None | $102.33 | $257.04 | $309.03 |
United Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $169.82 | Professional | None | $81.28 | $102.33 | $169.82 |
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 $186.21 Median $204.17 Typical High $204.17 | Professional | 50 · Both sides | $186.21 | $204.17 | $204.17 |
Where Pennsylvania sits
The same service costs 5.4 times more in Kansas 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· 25th of 51
$132
KS $575WV $107
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.