How much rates vary
Facilitymedian $62 · 10th to 90th $56 to $479Professionalmedian $47 · 10th to 90th $35 to $87
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 $35.48 Median $35.48 Typical High $39.81 | Facility | None | $35.48 | $35.48 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $41.69 | Professional | None | $35.48 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $19.95 Typical High $20.89 | Professional | 52 · Reduced service | $17.78 | $19.95 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.94 Typical High $8.32 | Professional | 53 · Discontinued | $7.08 | $7.94 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.89 Typical High $6.31 | Professional | 55 · Aftercare only | $5.37 | $5.89 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.98 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.55 | $3.98 | $4.17 |
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 $70.79 Median $87.10 Typical High $87.10 | Professional | None | $70.79 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $436.52 | Professional | None | $40.74 | $40.74 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $147.91 | Professional | None | $81.28 | $128.82 | $147.91 |
Geisinger Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Geisinger Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $89.13 | Professional | None | $48.98 | $57.54 | $89.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Martin's Point Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Martin's Point Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $41.69 | Professional | None | $35.48 | $39.81 | $41.69 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $19.95 Typical High $20.89 | Professional | 52 · Reduced service | $17.78 | $19.95 | $20.89 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.94 Typical High $8.32 | Professional | 53 · Discontinued | $7.08 | $7.94 | $8.32 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.89 Typical High $6.31 | Professional | 55 · Aftercare only | $5.37 | $5.89 | $6.31 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.98 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.55 | $3.98 | $4.17 |
Oscar Health Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $123.03 | Professional | None | $33.11 | $33.11 | $123.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $61.66 Median $281.84 Typical High $478.63 | Facility | None | $61.66 | $281.84 | $478.63 |
UPMC Health Plan Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | None | $61.66 | $61.66 | $83.18 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $128.82 | Facility | None | $107.15 | $107.15 | $128.82 |
United Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $72.44 | Professional | None | $33.88 | $43.65 | $72.44 |
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 $77.62 Median $87.10 Typical High $87.10 | Professional | 50 · Both sides | $77.62 | $87.10 | $87.10 |
Where Pennsylvania sits
The same service costs 3.1 times more in Hawaii than in Kansas. 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· 29th of 51
$48.98
HI $93.33KS $30.20
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.