How much rates vary
Facilitymedian $43 · 10th to 90th $34 to $331Professionalmedian $33 · 10th to 90th $25 to $60
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 $24.55 Median $24.55 Typical High $27.54 | Facility | None | $24.55 | $24.55 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $33.11 | Professional | None | $24.55 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $13.49 Typical High $14.45 | Professional | 52 · Reduced service | $12.30 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.50 Typical High $5.75 | Professional | 53 · Discontinued | $4.90 | $5.50 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.07 Typical High $4.37 | Professional | 55 · Aftercare only | $3.72 | $4.07 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.75 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.45 | $2.75 | $2.88 |
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 $48.98 Median $60.26 Typical High $60.26 | Professional | None | $48.98 | $60.26 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $302.00 | Professional | None | $25.12 | $25.12 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $56.23 Median $89.13 Typical High $102.33 | Professional | None | $56.23 | $89.13 | $102.33 |
Geisinger Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Geisinger Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $61.66 | Professional | None | $30.90 | $39.81 | $61.66 |
Highmark BCBS Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $44.67 | Professional | None | $41.69 | $44.67 | $44.67 |
Martin's Point Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Martin's Point Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $29.51 | Professional | None | $24.55 | $27.54 | $29.51 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $13.49 Typical High $14.45 | Professional | 52 · Reduced service | $12.30 | $13.49 | $14.45 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.50 Typical High $5.75 | Professional | 53 · Discontinued | $4.90 | $5.50 | $5.75 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.07 Typical High $4.37 | Professional | 55 · Aftercare only | $3.72 | $4.07 | $4.37 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.75 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.45 | $2.75 | $2.88 |
Oscar Health Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $85.11 | Professional | None | $21.38 | $21.38 | $85.11 |
UPMC Health Plan Setting Facility Modifier None Typical Low $42.66 Median $194.98 Typical High $331.13 | Facility | None | $42.66 | $194.98 | $331.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $89.13 | Facility | None | $74.13 | $74.13 | $89.13 |
United Setting Professional Modifier None Typical Low $23.44 Median $30.20 Typical High $45.71 | Professional | None | $23.44 | $30.20 | $45.71 |
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 $53.70 Median $60.26 Typical High $60.26 | Professional | 50 · Both sides | $53.70 | $60.26 | $60.26 |
Where Pennsylvania sits
The same service costs 2.8 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· 33rd of 51
$33.88
MT $64.57KS $23.44
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.