How much rates vary
Facilitymedian $65 · 10th to 90th $50 to $589Professionalmedian $60 · 10th to 90th $46 to $112
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 $45.71 Median $45.71 Typical High $51.29 | Facility | None | $45.71 | $45.71 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $53.70 | Professional | None | $45.71 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $25.70 Typical High $26.92 | Professional | 52 · Reduced service | $22.91 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.23 Typical High $10.72 | Professional | 53 · Discontinued | $9.12 | $10.23 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.59 Typical High $8.13 | Professional | 55 · Aftercare only | $6.92 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.13 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.57 | $5.13 | $5.37 |
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 $91.20 Median $112.20 Typical High $112.20 | Professional | None | $91.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $588.84 | Professional | None | $46.77 | $46.77 | $588.84 |
Emblem Health Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $177.83 | Professional | None | $97.72 | $151.36 | $177.83 |
Geisinger Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Geisinger Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $114.82 | Professional | None | $58.88 | $69.18 | $114.82 |
Martin's Point Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Martin's Point Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $53.70 | Professional | None | $45.71 | $51.29 | $53.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $25.70 Typical High $26.92 | Professional | 52 · Reduced service | $22.91 | $25.70 | $26.92 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.23 Typical High $10.72 | Professional | 53 · Discontinued | $9.12 | $10.23 | $10.72 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.59 Typical High $8.13 | Professional | 55 · Aftercare only | $6.92 | $7.59 | $8.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.13 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.57 | $5.13 | $5.37 |
Oscar Health Setting Professional Modifier None Typical Low $63.10 Median $147.91 Typical High $154.88 | Professional | None | $63.10 | $147.91 | $154.88 |
UPMC Health Plan Setting Facility Modifier None Typical Low $79.43 Median $363.08 Typical High $630.96 | Facility | None | $79.43 | $363.08 | $630.96 |
UPMC Health Plan Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
United Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $169.82 | Facility | None | $50.12 | $60.26 | $169.82 |
United Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $93.33 | Professional | None | $43.65 | $56.23 | $93.33 |
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 $100.00 Median $112.20 Typical High $112.20 | Professional | 50 · Both sides | $100.00 | $112.20 | $112.20 |
Where Pennsylvania sits
The same service costs 2.8 times more in Wisconsin 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· 33rd of 51
$64.57
WI $132DE $46.77
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.