How much rates vary
Facilitymedian $46 · 10th to 90th $37 to $355Professionalmedian $37 · 10th to 90th $26 to $65
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 $26.30 Median $26.30 Typical High $29.51 | Facility | None | $26.30 | $26.30 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $29.51 Typical High $30.90 | Professional | None | $26.30 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $14.79 Typical High $15.49 | Professional | 52 · Reduced service | $13.18 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.89 Typical High $6.17 | Professional | 53 · Discontinued | $5.25 | $5.89 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.37 Typical High $4.68 | Professional | 55 · Aftercare only | $3.98 | $4.37 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.95 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.63 | $2.95 | $3.09 |
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 $51.29 Median $64.57 Typical High $64.57 | Professional | None | $51.29 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $323.59 | Professional | None | $26.92 | $26.92 | $323.59 |
Emblem Health Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $109.65 | Professional | None | $60.26 | $95.50 | $109.65 |
Geisinger Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Geisinger Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $66.07 | Professional | None | $39.81 | $42.66 | $66.07 |
Martin's Point Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Martin's Point Setting Professional Modifier None Typical Low $26.30 Median $29.51 Typical High $30.90 | Professional | None | $26.30 | $29.51 | $30.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $14.79 Typical High $15.49 | Professional | 52 · Reduced service | $13.18 | $14.79 | $15.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.89 Typical High $6.17 | Professional | 53 · Discontinued | $5.25 | $5.89 | $6.17 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.37 Typical High $4.68 | Professional | 55 · Aftercare only | $3.98 | $4.37 | $4.68 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.95 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.63 | $2.95 | $3.09 |
Oscar Health Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $97.72 | Professional | None | $64.57 | $91.20 | $97.72 |
UPMC Health Plan Setting Facility Modifier None Typical Low $45.71 Median $208.93 Typical High $354.81 | Facility | None | $45.71 | $208.93 | $354.81 |
UPMC Health Plan Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $61.66 | Professional | None | $45.71 | $45.71 | $61.66 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $95.50 | Facility | None | $79.43 | $79.43 | $95.50 |
United Setting Professional Modifier None Typical Low $25.12 Median $32.36 Typical High $48.98 | Professional | None | $25.12 | $32.36 | $48.98 |
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 $57.54 Median $64.57 Typical High $64.57 | Professional | 50 · Both sides | $57.54 | $64.57 | $64.57 |
Where Pennsylvania sits
The same service costs 2.6 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· 29th of 51
$37.15
MT $69.18DE $26.92
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.