How much rates vary
Facilitymedian $98 · 10th to 90th $78 to $813Professionalmedian $89 · 10th to 90th $63 to $155
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 $63.10 Median $63.10 Typical High $69.18 | Facility | None | $63.10 | $63.10 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $74.13 | Professional | None | $63.10 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $34.67 Typical High $37.15 | Professional | 52 · Reduced service | $31.62 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.13 Typical High $14.79 | Professional | 53 · Discontinued | $12.59 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.47 Typical High $11.22 | Professional | 55 · Aftercare only | $9.55 | $10.47 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.08 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.31 | $7.08 | $7.41 |
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 $154.88 Typical High $154.88 | Professional | None | $123.03 | $154.88 | $154.88 |
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 $64.57 Median $64.57 Typical High $776.25 | Professional | None | $64.57 | $64.57 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $263.03 | Professional | None | $144.54 | $229.09 | $263.03 |
Geisinger Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Geisinger Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $158.49 | Professional | None | $81.28 | $93.33 | $158.49 |
Highmark BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $125.89 | Professional | None | $107.15 | $107.15 | $125.89 |
Martin's Point Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Martin's Point Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $74.13 | Professional | None | $63.10 | $69.18 | $74.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $34.67 Typical High $37.15 | Professional | 52 · Reduced service | $31.62 | $34.67 | $37.15 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.13 Typical High $14.79 | Professional | 53 · Discontinued | $12.59 | $14.13 | $14.79 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.47 Typical High $11.22 | Professional | 55 · Aftercare only | $9.55 | $10.47 | $11.22 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.08 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.31 | $7.08 | $7.41 |
Oscar Health Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $218.78 | Professional | None | $51.29 | $51.29 | $218.78 |
UPMC Health Plan Setting Facility Modifier None Typical Low $109.65 Median $501.19 Typical High $851.14 | Facility | None | $109.65 | $501.19 | $851.14 |
UPMC Health Plan Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $147.91 | Professional | None | $109.65 | $109.65 | $147.91 |
United Setting Facility Modifier None Typical Low $77.62 Median $190.55 Typical High $229.09 | Facility | None | $77.62 | $190.55 | $229.09 |
United Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $128.82 | Professional | None | $60.26 | $75.86 | $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 $138.04 Median $154.88 Typical High $154.88 | Professional | 50 · Both sides | $138.04 | $154.88 | $154.88 |
Where Pennsylvania sits
The same service costs 2.8 times more in Kansas 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· 28th of 51
$89.13
KS $178DE $64.57
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.