How much rates vary
Facilitymedian $54 · 10th to 90th $48 to $407Professionalmedian $42 · 10th to 90th $32 to $76
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 $31.62 Median $31.62 Typical High $34.67 | Facility | None | $31.62 | $31.62 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $36.31 | Professional | None | $31.62 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $17.38 Typical High $18.20 | Professional | 52 · Reduced service | $15.85 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.92 Typical High $7.41 | Professional | 53 · Discontinued | $6.31 | $6.92 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.25 Typical High $5.50 | Professional | 55 · Aftercare only | $4.68 | $5.25 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.47 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.16 | $3.47 | $3.63 |
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 $61.66 Median $75.86 Typical High $75.86 | Professional | None | $61.66 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $416.87 | Professional | None | $39.81 | $39.81 | $416.87 |
Emblem Health Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $158.49 | Professional | None | $87.10 | $134.90 | $158.49 |
Geisinger Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Geisinger Setting Professional Modifier None Typical Low $39.81 Median $46.77 Typical High $77.62 | Professional | None | $39.81 | $46.77 | $77.62 |
Highmark BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Martin's Point Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Martin's Point Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $36.31 | Professional | None | $31.62 | $34.67 | $36.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $17.38 Typical High $18.20 | Professional | 52 · Reduced service | $15.85 | $17.38 | $18.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.92 Typical High $7.41 | Professional | 53 · Discontinued | $6.31 | $6.92 | $7.41 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $5.25 Typical High $5.50 | Professional | 55 · Aftercare only | $4.68 | $5.25 | $5.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.47 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.16 | $3.47 | $3.63 |
Oscar Health Setting Professional Modifier None Typical Low $35.48 Median $56.23 Typical High $131.83 | Professional | None | $35.48 | $56.23 | $131.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $54.95 Median $245.47 Typical High $426.58 | Facility | None | $54.95 | $245.47 | $426.58 |
UPMC Health Plan Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $72.44 | Professional | None | $54.95 | $54.95 | $72.44 |
United Setting Facility Modifier None Typical Low $47.86 Median $51.29 Typical High $123.03 | Facility | None | $47.86 | $51.29 | $123.03 |
United Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $63.10 | Professional | None | $31.62 | $38.02 | $63.10 |
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 $69.18 Median $75.86 Typical High $75.86 | Professional | 50 · Both sides | $69.18 | $75.86 | $75.86 |
Where Pennsylvania sits
The same service costs 3.1 times more in Hawaii than in West Virginia. 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· 33rd of 51
$46.77
HI $123WV $39.81
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.