How much rates vary
Facilitymedian $135 · 10th to 90th $129 to $1,072Professionalmedian $112 · 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 $87.10 | Facility | None | $77.62 | $77.62 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $91.20 | Professional | None | $77.62 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $43.65 Typical High $45.71 | Professional | 52 · Reduced service | $38.90 | $43.65 | $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 $13.80 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.71 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.76 | $8.71 | $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 $151.36 Median $190.55 Typical High $190.55 | Professional | None | $151.36 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $954.99 | Professional | None | $95.50 | $95.50 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $323.59 | Professional | None | $177.83 | $281.84 | $323.59 |
Geisinger Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Geisinger Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $194.98 | Professional | None | $97.72 | $125.89 | $194.98 |
Highmark BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $87.10 Typical High $91.20 | Professional | None | $77.62 | $87.10 | $91.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $43.65 Typical High $45.71 | Professional | 52 · Reduced service | $38.90 | $43.65 | $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 $13.80 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $13.80 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.71 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.76 | $8.71 | $9.12 |
Oscar Health Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $269.15 | Professional | None | $61.66 | $61.66 | $269.15 |
UPMC Health Plan Setting Facility Modifier None Typical Low $134.90 Median $616.60 Typical High $1,071.52 | Facility | None | $134.90 | $616.60 | $1,071.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | None | $134.90 | $134.90 | $181.97 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Facility | None | $234.42 | $234.42 | $281.84 |
United Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $147.91 | Professional | None | $74.13 | $95.50 | $147.91 |
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 $169.82 Median $190.55 Typical High $190.55 | Professional | 50 · Both sides | $169.82 | $190.55 | $190.55 |
Where Pennsylvania sits
The same service costs 2.5 times more in Kansas than in Utah. 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
$123
KS $234UT $95.50
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.