How much rates vary
Facilitymedian $74 · 10th to 90th $66 to $537Professionalmedian $51 · 10th to 90th $40 to $95
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 $39.81 Median $39.81 Typical High $43.65 | Facility | None | $39.81 | $39.81 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $45.71 | Professional | None | $39.81 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $21.88 Typical High $22.91 | Professional | 52 · Reduced service | $19.50 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.71 Typical High $9.12 | Professional | 53 · Discontinued | $7.94 | $8.71 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.61 Typical High $6.92 | Professional | 55 · Aftercare only | $5.89 | $6.61 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.37 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.98 | $4.37 | $4.57 |
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 $77.62 Median $95.50 Typical High $95.50 | Professional | None | $77.62 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $478.63 | Professional | None | $48.98 | $48.98 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $162.18 | Professional | None | $89.13 | $141.25 | $162.18 |
Geisinger Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Geisinger Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $97.72 | Professional | None | $48.98 | $63.10 | $97.72 |
Highmark BCBS Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | None | $67.61 | $77.62 | $77.62 |
Martin's Point Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Martin's Point Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $45.71 | Professional | None | $39.81 | $43.65 | $45.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $21.88 Typical High $22.91 | Professional | 52 · Reduced service | $19.50 | $21.88 | $22.91 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.71 Typical High $9.12 | Professional | 53 · Discontinued | $7.94 | $8.71 | $9.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.61 Typical High $6.92 | Professional | 55 · Aftercare only | $5.89 | $6.61 | $6.92 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.37 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.98 | $4.37 | $4.57 |
Oscar Health Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $144.54 | Professional | None | $87.10 | $138.04 | $144.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $69.18 Median $309.03 Typical High $537.03 | Facility | None | $69.18 | $309.03 | $537.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $91.20 | Professional | None | $69.18 | $69.18 | $91.20 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $144.54 | Facility | None | $120.23 | $120.23 | $144.54 |
United Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $74.13 | Professional | None | $37.15 | $47.86 | $74.13 |
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 $87.10 Median $95.50 Typical High $95.50 | Professional | 50 · Both sides | $87.10 | $95.50 | $95.50 |
Cigna Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | RR · Rental | $6.61 | $6.61 | $6.61 |
Where Pennsylvania sits
The same service costs 2.0 times more in Montana than in Vermont. 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· 28th of 51
$56.23
MT $100VT $48.98
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.