How much rates vary
Facilitymedian $145 · 10th to 90th $100 to $1,318Professionalmedian $135 · 10th to 90th $102 to $251
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 $102.33 Median $102.33 Typical High $112.20 | Facility | None | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $120.23 | Professional | None | $102.33 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $56.23 Typical High $60.26 | Professional | 52 · Reduced service | $51.29 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.91 Typical High $23.99 | Professional | 53 · Discontinued | $20.42 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.98 Typical High $17.78 | Professional | 55 · Aftercare only | $15.49 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.22 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.23 | $11.22 | $12.02 |
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 $204.17 Median $251.19 Typical High $251.19 | Professional | None | $204.17 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $1,122.02 | Professional | None | $104.71 | $104.71 | $1,122.02 |
Emblem Health Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $338.84 | Professional | None | $186.21 | $295.12 | $338.84 |
Geisinger Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Geisinger Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $251.19 | Professional | None | $131.83 | $151.36 | $251.19 |
Martin's Point Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $120.23 | Professional | None | $102.33 | $112.20 | $120.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $56.23 Typical High $60.26 | Professional | 52 · Reduced service | $51.29 | $56.23 | $60.26 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.91 Typical High $23.99 | Professional | 53 · Discontinued | $20.42 | $22.91 | $23.99 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.98 Typical High $17.78 | Professional | 55 · Aftercare only | $15.49 | $16.98 | $17.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.22 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.23 | $11.22 | $12.02 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $288.40 Typical High $302.00 | Professional | None | $123.03 | $288.40 | $302.00 |
UPMC Health Plan Setting Facility Modifier None Typical Low $177.83 Median $812.83 Typical High $1,380.38 | Facility | None | $177.83 | $812.83 | $1,380.38 |
UPMC Health Plan Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $234.42 | Professional | None | $177.83 | $177.83 | $234.42 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $323.59 | Facility | None | $87.10 | $100.00 | $323.59 |
United Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $186.21 | Professional | None | $91.20 | $123.03 | $186.21 |
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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 50 · Both sides | $223.87 | $251.19 | $251.19 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | KX · Policy requirements met | $186.21 | $186.21 | $186.21 |
Where Pennsylvania sits
The same service costs 2.5 times more in Montana than in Florida. 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· 24th of 51
$135
MT $263FL $105
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.