How much rates vary
Facilitymedian $219 · 10th to 90th $166 to $2,138Professionalmedian $219 · 10th to 90th $158 to $407
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 $165.96 Median $165.96 Typical High $186.21 | Facility | None | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $194.98 | Professional | None | $165.96 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $93.33 Typical High $97.72 | Professional | 52 · Reduced service | $83.18 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $37.15 Typical High $38.90 | Professional | 53 · Discontinued | $33.11 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $27.54 Typical High $29.51 | Professional | 55 · Aftercare only | $25.12 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.62 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.60 | $18.62 | $19.50 |
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 $331.13 Median $407.38 Typical High $407.38 | Professional | None | $331.13 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $1,819.70 | Professional | None | $158.49 | $158.49 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $776.25 | Professional | None | $426.58 | $660.69 | $776.25 |
Geisinger Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Geisinger Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $416.87 | Professional | None | $213.80 | $251.19 | $416.87 |
Martin's Point Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $194.98 | Professional | None | $165.96 | $186.21 | $194.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $93.33 Typical High $97.72 | Professional | 52 · Reduced service | $83.18 | $93.33 | $97.72 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $37.15 Typical High $38.90 | Professional | 53 · Discontinued | $33.11 | $37.15 | $38.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $27.54 Typical High $29.51 | Professional | 55 · Aftercare only | $25.12 | $27.54 | $29.51 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.62 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.60 | $18.62 | $19.50 |
Oscar Health Setting Professional Modifier None Typical Low $275.42 Median $645.65 Typical High $676.08 | Professional | None | $275.42 | $645.65 | $676.08 |
UPMC Health Plan Setting Facility Modifier None Typical Low $288.40 Median $1,318.26 Typical High $2,290.87 | Facility | None | $288.40 | $1,318.26 | $2,290.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Professional | None | $288.40 | $288.40 | $389.05 |
United Setting Facility Modifier None Typical Low $36.31 Median $169.82 Typical High $549.54 | Facility | None | $36.31 | $169.82 | $549.54 |
United Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $316.23 | Professional | None | $151.36 | $204.17 | $316.23 |
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 $363.08 Median $407.38 Typical High $407.38 | Professional | 50 · Both sides | $363.08 | $407.38 | $407.38 |
Where Pennsylvania sits
The same service costs 3.6 times more in Georgia than in Alaska. 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· 21st of 51
$219
GA $372AK $102
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.