How much rates vary
Facilitymedian $32 · 10th to 90th $27 to $251Professionalmedian $27 · 10th to 90th $19 to $45
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 $18.62 Median $18.62 Typical High $20.42 | Facility | None | $18.62 | $18.62 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $21.38 | Professional | None | $18.62 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $10.23 Typical High $10.72 | Professional | 52 · Reduced service | $9.33 | $10.23 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.07 Typical High $4.37 | Professional | 53 · Discontinued | $3.72 | $4.07 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.09 Typical High $3.24 | Professional | 55 · Aftercare only | $2.75 | $3.09 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.04 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.86 | $2.04 | $2.14 |
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 $36.31 Median $44.67 Typical High $44.67 | Professional | None | $36.31 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $223.87 | Professional | None | $19.95 | $19.95 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $41.69 Median $66.07 Typical High $77.62 | Professional | None | $41.69 | $66.07 | $77.62 |
Geisinger Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Geisinger Setting Professional Modifier None Typical Low $27.54 Median $32.36 Typical High $45.71 | Professional | None | $27.54 | $32.36 | $45.71 |
Highmark BCBS Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Martin's Point Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Martin's Point Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $21.38 | Professional | None | $18.62 | $20.42 | $21.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $10.23 Typical High $10.72 | Professional | 52 · Reduced service | $9.33 | $10.23 | $10.72 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.07 Typical High $4.37 | Professional | 53 · Discontinued | $3.72 | $4.07 | $4.37 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.09 Typical High $3.24 | Professional | 55 · Aftercare only | $2.75 | $3.09 | $3.24 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.04 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.86 | $2.04 | $2.14 |
Oscar Health Setting Professional Modifier None Typical Low $17.78 Median $40.74 Typical High $64.57 | Professional | None | $17.78 | $40.74 | $64.57 |
UPMC Health Plan Setting Facility Modifier None Typical Low $32.36 Median $144.54 Typical High $251.19 | Facility | None | $32.36 | $144.54 | $251.19 |
UPMC Health Plan Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $42.66 | Professional | None | $32.36 | $32.36 | $42.66 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $67.61 | Facility | None | $56.23 | $56.23 | $67.61 |
United Setting Professional Modifier None Typical Low $17.38 Median $22.39 Typical High $33.88 | Professional | None | $17.38 | $22.39 | $33.88 |
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 $40.74 Median $44.67 Typical High $44.67 | Professional | 50 · Both sides | $40.74 | $44.67 | $44.67 |
Where Pennsylvania sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 25th of 51
$26.92
MT $48.98DE $19.95
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.