How much rates vary
Facilitymedian $85 · 10th to 90th $63 to $575Professionalmedian $59 · 10th to 90th $44 to $107
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 $43.65 Median $43.65 Typical High $48.98 | Facility | None | $43.65 | $43.65 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $51.29 | Professional | None | $43.65 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $24.55 Typical High $25.70 | Professional | 52 · Reduced service | $21.88 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.77 Typical High $10.23 | Professional | 53 · Discontinued | $8.71 | $9.77 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.24 Typical High $7.76 | Professional | 55 · Aftercare only | $6.61 | $7.24 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.90 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.37 | $4.90 | $5.13 |
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 $87.10 Median $107.15 Typical High $107.15 | Professional | None | $87.10 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $524.81 | Professional | None | $58.88 | $58.88 | $524.81 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $162.18 | Professional | None | $89.13 | $138.04 | $162.18 |
Geisinger Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Geisinger Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $109.65 | Professional | None | $57.54 | $66.07 | $109.65 |
Martin's Point Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $51.29 | Professional | None | $43.65 | $48.98 | $51.29 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $24.55 Typical High $25.70 | Professional | 52 · Reduced service | $21.88 | $24.55 | $25.70 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.77 Typical High $10.23 | Professional | 53 · Discontinued | $8.71 | $9.77 | $10.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.24 Typical High $7.76 | Professional | 55 · Aftercare only | $6.61 | $7.24 | $7.76 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.90 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.37 | $4.90 | $5.13 |
Oscar Health Setting Professional Modifier None Typical Low $57.54 Median $134.90 Typical High $141.25 | Professional | None | $57.54 | $134.90 | $141.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $75.86 Median $346.74 Typical High $602.56 | Facility | None | $75.86 | $346.74 | $602.56 |
UPMC Health Plan Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | None | $75.86 | $75.86 | $102.33 |
United Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $154.88 | Facility | None | $63.10 | $93.33 | $154.88 |
United Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $87.10 | Professional | None | $41.69 | $53.70 | $87.10 |
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 $95.50 Median $107.15 Typical High $107.15 | Professional | 50 · Both sides | $95.50 | $107.15 | $107.15 |
Where Pennsylvania sits
The same service costs 4.4 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· 24th of 51
$63.10
HI $219FL $50.12
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.