How much rates vary
Facilitymedian $72 · 10th to 90th $65 to $525Professionalmedian $52 · 10th to 90th $40 to $93
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 $39.81 Median $44.67 Typical High $72.44 | Facility | None | $39.81 | $44.67 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $61.66 | Professional | None | $39.81 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $22.39 Typical High $23.44 | Professional | 52 · Reduced service | $19.95 | $22.39 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.91 Typical High $9.33 | Professional | 53 · Discontinued | $8.13 | $8.91 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.61 Typical High $7.08 | Professional | 55 · Aftercare only | $6.03 | $6.61 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.47 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.07 | $4.47 | $4.68 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $85.11 | Professional | None | $56.23 | $56.23 | $85.11 |
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 $74.13 Median $74.13 Typical High $79.43 | Professional | None | $74.13 | $74.13 | $79.43 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 50 · Both sides | $89.13 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $588.84 | Professional | None | $52.48 | $52.48 | $588.84 |
Emblem Health Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $190.55 | Professional | None | $104.71 | $165.96 | $190.55 |
Geisinger Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Geisinger Setting Professional Modifier None Typical Low $52.48 Median $60.26 Typical High $100.00 | Professional | None | $52.48 | $60.26 | $100.00 |
Highmark BCBS Setting Facility Modifier None Typical Low $52.48 Median $446.68 Typical High $602.56 | Facility | None | $52.48 | $446.68 | $602.56 |
Highmark BCBS Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $85.11 | Professional | None | $69.18 | $74.13 | $85.11 |
Martin's Point Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Martin's Point Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $61.66 | Professional | None | $39.81 | $44.67 | $61.66 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $22.39 Typical High $23.44 | Professional | 52 · Reduced service | $19.95 | $22.39 | $23.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.91 Typical High $9.33 | Professional | 53 · Discontinued | $8.13 | $8.91 | $9.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.61 Typical High $7.08 | Professional | 55 · Aftercare only | $6.03 | $6.61 | $7.08 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.47 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.07 | $4.47 | $4.68 |
Oscar Health Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $162.18 | Professional | None | $37.15 | $37.15 | $162.18 |
UPMC Health Plan Setting Facility Modifier None Typical Low $67.61 Median $316.23 Typical High $549.54 | Facility | None | $67.61 | $316.23 | $549.54 |
UPMC Health Plan Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $93.33 | Professional | None | $67.61 | $67.61 | $93.33 |
United Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $158.49 | Facility | None | $64.57 | $100.00 | $158.49 |
United Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $81.28 | Professional | None | $38.90 | $48.98 | $81.28 |
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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $69.18 Median $77.62 Typical High $79.43 | Professional | KX · Policy requirements met | $69.18 | $77.62 | $79.43 |
Where Pennsylvania sits
The same service costs 5.0 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· 43rd of 51
$52.48
HI $257FL $51.29
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.