How much rates vary
Facilitymedian $100 · 10th to 90th $95 to $794Professionalmedian $85 · 10th to 90th $62 to $151
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 $61.66 Median $61.66 Typical High $69.18 | Facility | None | $61.66 | $61.66 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $74.13 | Professional | None | $61.66 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $34.67 Typical High $36.31 | Professional | 52 · Reduced service | $30.90 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.80 Typical High $14.45 | Professional | 53 · Discontinued | $12.30 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.23 Typical High $10.96 | Professional | 55 · Aftercare only | $9.33 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.92 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.17 | $6.92 | $7.24 |
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 $123.03 Median $151.36 Typical High $151.36 | Professional | None | $123.03 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $851.14 | Professional | None | $70.79 | $70.79 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $257.04 | Professional | None | $141.25 | $223.87 | $257.04 |
Geisinger Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Geisinger Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $154.88 | Professional | None | $79.43 | $93.33 | $154.88 |
Highmark BCBS Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Martin's Point Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Martin's Point Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $72.44 | Professional | None | $61.66 | $69.18 | $72.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $34.67 Typical High $36.31 | Professional | 52 · Reduced service | $30.90 | $34.67 | $36.31 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.80 Typical High $14.45 | Professional | 53 · Discontinued | $12.30 | $13.80 | $14.45 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.23 Typical High $10.96 | Professional | 55 · Aftercare only | $9.33 | $10.23 | $10.96 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.92 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.17 | $6.92 | $7.24 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $213.80 Typical High $229.09 | Professional | None | $93.33 | $213.80 | $229.09 |
UPMC Health Plan Setting Facility Modifier None Typical Low $107.15 Median $489.78 Typical High $851.14 | Facility | None | $107.15 | $489.78 | $851.14 |
UPMC Health Plan Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | None | $107.15 | $107.15 | $144.54 |
United Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $245.47 | Facility | None | $95.50 | $100.00 | $245.47 |
United Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $125.89 | Professional | None | $61.66 | $75.86 | $125.89 |
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 $134.90 Median $151.36 Typical High $151.36 | Professional | 50 · Both sides | $134.90 | $151.36 | $151.36 |
Where Pennsylvania sits
The same service costs 3.2 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· 31st of 51
$93.33
HI $224FL $70.79
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.