How much rates vary
Facilitymedian $36 · 10th to 90th $35 to $282Professionalmedian $31 · 10th to 90th $21 to $51
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 $20.89 Median $20.89 Typical High $22.91 | Facility | None | $20.89 | $20.89 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $22.91 Typical High $24.55 | Professional | None | $20.89 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $11.48 Typical High $12.30 | Professional | 52 · Reduced service | $10.47 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.68 Typical High $4.90 | Professional | 53 · Discontinued | $4.17 | $4.68 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.47 Typical High $3.63 | Professional | 55 · Aftercare only | $3.16 | $3.47 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.29 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.09 | $2.29 | $2.45 |
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 $40.74 Median $51.29 Typical High $51.29 | Professional | None | $40.74 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $257.04 | Professional | None | $25.70 | $25.70 | $257.04 |
Emblem Health Setting Professional Modifier None Typical Low $47.86 Median $75.86 Typical High $87.10 | Professional | None | $47.86 | $75.86 | $87.10 |
Geisinger Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Geisinger Setting Professional Modifier None Typical Low $26.30 Median $33.88 Typical High $51.29 | Professional | None | $26.30 | $33.88 | $51.29 |
Martin's Point Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Martin's Point Setting Professional Modifier None Typical Low $20.89 Median $22.91 Typical High $24.55 | Professional | None | $20.89 | $22.91 | $24.55 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $11.48 Typical High $12.30 | Professional | 52 · Reduced service | $10.47 | $11.48 | $12.30 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.68 Typical High $4.90 | Professional | 53 · Discontinued | $4.17 | $4.68 | $4.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.47 Typical High $3.63 | Professional | 55 · Aftercare only | $3.16 | $3.47 | $3.63 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.29 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.09 | $2.29 | $2.45 |
Oscar Health Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $72.44 | Professional | None | $10.72 | $10.72 | $72.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $36.31 Median $165.96 Typical High $281.84 | Facility | None | $36.31 | $165.96 | $281.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $47.86 | Professional | None | $36.31 | $36.31 | $47.86 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Facility | None | $63.10 | $63.10 | $75.86 |
United Setting Professional Modifier None Typical Low $19.95 Median $25.12 Typical High $38.90 | Professional | None | $19.95 | $25.12 | $38.90 |
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 $45.71 Median $51.29 Typical High $51.29 | Professional | 50 · Both sides | $45.71 | $51.29 | $51.29 |
Where Pennsylvania sits
The same service costs 2.1 times more in Montana than in New Jersey. 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
$30.90
MT $54.95NJ $25.70
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.