How much rates vary
Facilitymedian $27 · 10th to 90th $21 to $209Professionalmedian $20 · 10th to 90th $15 to $37
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 $15.49 Median $15.49 Typical High $16.98 | Facility | None | $15.49 | $15.49 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $16.98 Typical High $17.78 | Professional | None | $15.49 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $8.51 Typical High $8.91 | Professional | 52 · Reduced service | $7.76 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.39 Typical High $3.63 | Professional | 53 · Discontinued | $3.09 | $3.39 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.51 Typical High $2.69 | Professional | 55 · Aftercare only | $2.29 | $2.51 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.70 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.55 | $1.70 | $1.82 |
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 $30.20 Median $37.15 Typical High $37.15 | Professional | None | $30.20 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $186.21 | Professional | None | $15.49 | $15.49 | $186.21 |
Emblem Health Setting Professional Modifier None Typical Low $34.67 Median $54.95 Typical High $64.57 | Professional | None | $34.67 | $54.95 | $64.57 |
Geisinger Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Geisinger Setting Professional Modifier None Typical Low $21.38 Median $24.55 Typical High $38.02 | Professional | None | $21.38 | $24.55 | $38.02 |
Martin's Point Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier None Typical Low $15.49 Median $16.98 Typical High $17.78 | Professional | None | $15.49 | $16.98 | $17.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $8.51 Typical High $8.91 | Professional | 52 · Reduced service | $7.76 | $8.51 | $8.91 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.39 Typical High $3.63 | Professional | 53 · Discontinued | $3.09 | $3.39 | $3.63 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.51 Typical High $2.69 | Professional | 55 · Aftercare only | $2.29 | $2.51 | $2.69 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.70 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.55 | $1.70 | $1.82 |
Oscar Health Setting Professional Modifier None Typical Low $38.02 Median $53.70 Typical High $56.23 | Professional | None | $38.02 | $53.70 | $56.23 |
UPMC Health Plan Setting Facility Modifier None Typical Low $26.92 Median $120.23 Typical High $208.93 | Facility | None | $26.92 | $120.23 | $208.93 |
UPMC Health Plan Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $35.48 | Professional | None | $26.92 | $26.92 | $35.48 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $56.23 | Facility | None | $46.77 | $46.77 | $56.23 |
United Setting Professional Modifier None Typical Low $14.45 Median $18.62 Typical High $28.18 | Professional | None | $14.45 | $18.62 | $28.18 |
2 more rates 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 $33.88 Median $37.15 Typical High $37.15 | Professional | 50 · Both sides | $33.88 | $37.15 | $37.15 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | KX · Policy requirements met | $31.62 | $31.62 | $31.62 |
Where Pennsylvania sits
The same service costs 2.9 times more in Montana 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· 27th of 51
$21.38
MT $40.74KS $14.13
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.