How much rates vary
Facilitymedian $120 · 10th to 90th $85 to $1,122Professionalmedian $115 · 10th to 90th $87 to $214
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 $87.10 Median $87.10 Typical High $97.72 | Facility | None | $87.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $102.33 | Professional | None | $87.10 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $47.86 Typical High $51.29 | Professional | 52 · Reduced service | $43.65 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.50 Typical High $20.42 | Professional | 53 · Discontinued | $17.38 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.45 Typical High $15.49 | Professional | 55 · Aftercare only | $13.18 | $14.45 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.77 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.71 | $9.77 | $10.23 |
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 $173.78 Median $213.80 Typical High $213.80 | Professional | None | $173.78 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $933.25 | Professional | None | $87.10 | $87.10 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $316.23 | Professional | None | $173.78 | $275.42 | $316.23 |
Geisinger Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Geisinger Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $218.78 | Professional | None | $112.20 | $128.82 | $218.78 |
Martin's Point Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $102.33 | Professional | None | $87.10 | $97.72 | $102.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $47.86 Typical High $51.29 | Professional | 52 · Reduced service | $43.65 | $47.86 | $51.29 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.50 Typical High $20.42 | Professional | 53 · Discontinued | $17.38 | $19.50 | $20.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.45 Typical High $15.49 | Professional | 55 · Aftercare only | $13.18 | $14.45 | $15.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.77 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.71 | $9.77 | $10.23 |
Oscar Health Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $281.84 | Professional | None | $114.82 | $194.98 | $281.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $151.36 Median $691.83 Typical High $1,174.90 | Facility | None | $151.36 | $691.83 | $1,174.90 |
UPMC Health Plan Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | None | $151.36 | $151.36 | $204.17 |
United Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $275.42 | Facility | None | $72.44 | $85.11 | $275.42 |
United Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $158.49 | Professional | None | $77.62 | $104.71 | $158.49 |
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 $190.55 Median $213.80 Typical High $213.80 | Professional | 50 · Both sides | $190.55 | $213.80 | $213.80 |
Where Pennsylvania sits
The same service costs 2.4 times more in Montana than in Vermont. 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· 22nd of 51
$115
MT $209VT $87.10
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.