How much rates vary
Facilitymedian $110 · 10th to 90th $89 to $1,000Professionalmedian $102 · 10th to 90th $78 to $191
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 $77.62 Median $77.62 Typical High $85.11 | Facility | None | $77.62 | $77.62 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $91.20 | Professional | None | $77.62 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $42.66 Typical High $45.71 | Professional | 52 · Reduced service | $38.90 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $17.38 Typical High $18.20 | Professional | 53 · Discontinued | $15.49 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.88 Typical High $13.49 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.51 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.76 | $8.51 | $9.12 |
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 $154.88 Median $190.55 Typical High $190.55 | Professional | None | $154.88 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $954.99 | Professional | None | $81.28 | $81.28 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $380.19 | Professional | None | $208.93 | $323.59 | $380.19 |
Geisinger Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Geisinger Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $190.55 | Professional | None | $100.00 | $114.82 | $190.55 |
Martin's Point Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Martin's Point Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $91.20 | Professional | None | $77.62 | $85.11 | $91.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $42.66 Typical High $45.71 | Professional | 52 · Reduced service | $38.90 | $42.66 | $45.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $17.38 Typical High $18.20 | Professional | 53 · Discontinued | $15.49 | $17.38 | $18.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.88 Typical High $13.49 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $13.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.51 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.76 | $8.51 | $9.12 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $331.13 | Professional | None | $134.90 | $229.09 | $331.13 |
UPMC Health Plan Setting Facility Modifier None Typical Low $134.90 Median $616.60 Typical High $1,047.13 | Facility | None | $134.90 | $616.60 | $1,047.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $177.83 | Professional | None | $134.90 | $134.90 | $177.83 |
United Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $288.40 | Facility | None | $89.13 | $107.15 | $288.40 |
United Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $158.49 | Professional | None | $74.13 | $93.33 | $158.49 |
2 more rates 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 $169.82 Median $190.55 Typical High $190.55 | Professional | 50 · Both sides | $169.82 | $190.55 | $190.55 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | KX · Policy requirements met | $141.25 | $141.25 | $141.25 |
Where Pennsylvania sits
The same service costs 3.0 times more in Montana 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· 24th of 51
$110
MT $240DE $81.28
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.