How much rates vary
Facilitymedian $41 · 10th to 90th $35 to $282Professionalmedian $29 · 10th to 90th $22 to $54
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 $21.88 Median $21.88 Typical High $24.55 | Facility | None | $21.88 | $21.88 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $24.55 Typical High $25.70 | Professional | None | $21.88 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $12.30 Typical High $12.88 | Professional | 52 · Reduced service | $10.96 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.90 Typical High $5.13 | Professional | 53 · Discontinued | $4.37 | $4.90 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.63 Typical High $3.89 | Professional | 55 · Aftercare only | $3.31 | $3.63 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.45 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.19 | $2.45 | $2.57 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $43.65 Median $53.70 Typical High $53.70 | Professional | None | $43.65 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $309.03 | Professional | None | $28.84 | $28.84 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $95.50 | Professional | None | $52.48 | $81.28 | $95.50 |
Geisinger Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Geisinger Setting Professional Modifier None Typical Low $28.18 Median $33.11 Typical High $54.95 | Professional | None | $28.18 | $33.11 | $54.95 |
Highmark BCBS Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Highmark BCBS Setting Professional Modifier None Typical Low $37.15 Median $39.81 Typical High $43.65 | Professional | None | $37.15 | $39.81 | $43.65 |
Martin's Point Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Martin's Point Setting Professional Modifier None Typical Low $21.88 Median $24.55 Typical High $25.70 | Professional | None | $21.88 | $24.55 | $25.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $12.30 Typical High $12.88 | Professional | 52 · Reduced service | $10.96 | $12.30 | $12.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.90 Typical High $5.13 | Professional | 53 · Discontinued | $4.37 | $4.90 | $5.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.63 Typical High $3.89 | Professional | 55 · Aftercare only | $3.31 | $3.63 | $3.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.45 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.19 | $2.45 | $2.57 |
Oscar Health Setting Professional Modifier None Typical Low $21.88 Median $51.29 Typical High $79.43 | Professional | None | $21.88 | $51.29 | $79.43 |
UPMC Health Plan Setting Facility Modifier None Typical Low $38.02 Median $173.78 Typical High $302.00 | Facility | None | $38.02 | $173.78 | $302.00 |
UPMC Health Plan Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
United Setting Facility Modifier None Typical Low $35.48 Median $51.29 Typical High $87.10 | Facility | None | $35.48 | $51.29 | $87.10 |
United Setting Professional Modifier None Typical Low $21.88 Median $26.92 Typical High $44.67 | Professional | None | $21.88 | $26.92 | $44.67 |
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 $47.86 Median $53.70 Typical High $53.70 | Professional | 50 · Both sides | $47.86 | $53.70 | $53.70 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $37.15 Median $39.81 Typical High $41.69 | Professional | KX · Policy requirements met | $37.15 | $39.81 | $41.69 |
Where Pennsylvania sits
The same service costs 4.7 times more in Hawaii 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· 30th of 51
$33.11
HI $132FL $28.18
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.