How much rates vary
Facilitymedian $115 · 10th to 90th $89 to $851Professionalmedian $89 · 10th to 90th $66 to $162
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 $66.07 Median $66.07 Typical High $74.13 | Facility | None | $66.07 | $66.07 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $77.62 | Professional | None | $66.07 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $13.18 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $11.75 | Professional | 55 · Aftercare only | $10.00 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.61 | $7.41 | $7.76 |
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 $128.82 Median $162.18 Typical High $162.18 | Professional | None | $128.82 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $776.25 | Professional | None | $66.07 | $66.07 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $239.88 | Professional | None | $128.82 | $204.17 | $239.88 |
Geisinger Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Geisinger Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $165.96 | Professional | None | $85.11 | $97.72 | $165.96 |
Martin's Point Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Martin's Point Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $77.62 | Professional | None | $66.07 | $74.13 | $77.62 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $36.31 | $38.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $13.18 | $14.79 | $15.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $11.75 | Professional | 55 · Aftercare only | $10.00 | $10.96 | $11.75 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.61 | $7.41 | $7.76 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $208.93 | Professional | None | $85.11 | $199.53 | $208.93 |
UPMC Health Plan Setting Facility Modifier None Typical Low $114.82 Median $524.81 Typical High $891.25 | Facility | None | $114.82 | $524.81 | $891.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | None | $114.82 | $114.82 | $154.88 |
United Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $223.87 | Facility | None | $93.33 | $114.82 | $223.87 |
United Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $128.82 | Professional | None | $63.10 | $79.43 | $128.82 |
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 $144.54 Median $162.18 Typical High $162.18 | Professional | 50 · Both sides | $144.54 | $162.18 | $162.18 |
Where Pennsylvania sits
The same service costs 5.1 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· 27th of 51
$89.13
HI $339DE $66.07
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.