How much rates vary
Facilitymedian $170 · 10th to 90th $141 to $1,585Professionalmedian $158 · 10th to 90th $117 to $302
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 $123.03 Median $123.03 Typical High $134.90 | Facility | None | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | None | $123.03 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $67.61 Typical High $72.44 | Professional | 52 · Reduced service | $61.66 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $27.54 Typical High $28.84 | Professional | 53 · Discontinued | $24.55 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $21.88 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $14.45 |
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 $245.47 Median $302.00 Typical High $302.00 | Professional | None | $245.47 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $1,479.11 | Professional | None | $117.49 | $117.49 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $436.52 | Professional | None | $239.88 | $380.19 | $436.52 |
Geisinger Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Geisinger Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $309.03 | Professional | None | $158.49 | $181.97 | $309.03 |
Martin's Point Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | None | $123.03 | $134.90 | $144.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $67.61 Typical High $72.44 | Professional | 52 · Reduced service | $61.66 | $67.61 | $72.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $27.54 Typical High $28.84 | Professional | 53 · Discontinued | $24.55 | $27.54 | $28.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $21.88 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $21.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $14.45 |
Oscar Health Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $389.05 | Professional | None | $158.49 | $269.15 | $389.05 |
UPMC Health Plan Setting Facility Modifier None Typical Low $213.80 Median $977.24 Typical High $1,659.59 | Facility | None | $213.80 | $977.24 | $1,659.59 |
UPMC Health Plan Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $288.40 | Professional | None | $213.80 | $213.80 | $288.40 |
United Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $416.87 | Facility | None | $141.25 | $169.82 | $416.87 |
United Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $234.42 | Professional | None | $114.82 | $147.91 | $234.42 |
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 $269.15 Median $302.00 Typical High $302.00 | Professional | 50 · Both sides | $269.15 | $302.00 | $302.00 |
Where Pennsylvania sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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
$158
HI $468KS $107
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.