How much rates vary
Facilitymedian $63 · 10th to 90th $62 to $490Professionalmedian $50 · 10th to 90th $38 to $93
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 $38.02 Median $38.02 Typical High $41.69 | Facility | None | $38.02 | $38.02 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $44.67 | Professional | None | $38.02 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $20.89 Typical High $22.39 | Professional | 52 · Reduced service | $19.05 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $8.32 Typical High $8.91 | Professional | 53 · Discontinued | $7.59 | $8.32 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.31 Typical High $6.61 | Professional | 55 · Aftercare only | $5.75 | $6.31 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.17 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.80 | $4.17 | $4.47 |
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 $75.86 Median $93.33 Typical High $93.33 | Professional | None | $75.86 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $512.86 | Professional | None | $45.71 | $45.71 | $512.86 |
Emblem Health Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $177.83 | Professional | None | $97.72 | $154.88 | $177.83 |
Geisinger Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Geisinger Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $93.33 | Professional | None | $48.98 | $56.23 | $93.33 |
Highmark BCBS Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Highmark BCBS Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $75.86 | Professional | None | $64.57 | $72.44 | $75.86 |
Martin's Point Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Martin's Point Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $44.67 | Professional | None | $38.02 | $41.69 | $44.67 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $20.89 Typical High $22.39 | Professional | 52 · Reduced service | $19.05 | $20.89 | $22.39 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $8.32 Typical High $8.91 | Professional | 53 · Discontinued | $7.59 | $8.32 | $8.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.31 Typical High $6.61 | Professional | 55 · Aftercare only | $5.75 | $6.31 | $6.61 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.17 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.80 | $4.17 | $4.47 |
Oscar Health Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $158.49 | Professional | None | $64.57 | $109.65 | $158.49 |
UPMC Health Plan Setting Facility Modifier None Typical Low $66.07 Median $302.00 Typical High $512.86 | Facility | None | $66.07 | $302.00 | $512.86 |
UPMC Health Plan Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $87.10 | Professional | None | $66.07 | $66.07 | $87.10 |
United Setting Facility Modifier None Typical Low $61.66 Median $63.10 Typical High $151.36 | Facility | None | $61.66 | $63.10 | $151.36 |
United Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $75.86 | Professional | None | $38.02 | $45.71 | $75.86 |
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 $83.18 Median $93.33 Typical High $93.33 | Professional | 50 · Both sides | $83.18 | $93.33 | $93.33 |
Where Pennsylvania sits
The same service costs 4.3 times more in Hawaii 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· 34th of 51
$56.23
HI $195DE $45.71
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.