How much rates vary
Facilitymedian $89 · 10th to 90th $71 to $692Professionalmedian $71 · 10th to 90th $51 to $123
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 $51.29 Median $51.29 Typical High $56.23 | Facility | None | $51.29 | $51.29 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $60.26 | Professional | None | $51.29 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $28.18 Typical High $30.20 | Professional | 52 · Reduced service | $25.70 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $11.22 Typical High $12.02 | Professional | 53 · Discontinued | $10.23 | $11.22 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.51 Typical High $8.91 | Professional | 55 · Aftercare only | $7.59 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.62 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.13 | $5.62 | $6.03 |
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 $100.00 Median $123.03 Typical High $123.03 | Professional | None | $100.00 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $616.60 | Professional | None | $51.29 | $51.29 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $213.80 | Professional | None | $117.49 | $181.97 | $213.80 |
Geisinger Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Geisinger Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $125.89 | Professional | None | $64.57 | $83.18 | $125.89 |
Martin's Point Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Martin's Point Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $60.26 | Professional | None | $51.29 | $56.23 | $60.26 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $28.18 Typical High $30.20 | Professional | 52 · Reduced service | $25.70 | $28.18 | $30.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $11.22 Typical High $12.02 | Professional | 53 · Discontinued | $10.23 | $11.22 | $12.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.51 Typical High $8.91 | Professional | 55 · Aftercare only | $7.59 | $8.51 | $8.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.62 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.13 | $5.62 | $6.03 |
Oscar Health Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $186.21 | Professional | None | $125.89 | $177.83 | $186.21 |
UPMC Health Plan Setting Facility Modifier None Typical Low $89.13 Median $407.38 Typical High $691.83 | Facility | None | $89.13 | $407.38 | $691.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | None | $89.13 | $89.13 | $117.49 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $186.21 | Facility | None | $154.88 | $154.88 | $186.21 |
United Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $95.50 | Professional | None | $48.98 | $61.66 | $95.50 |
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 $112.20 Median $123.03 Typical High $123.03 | Professional | 50 · Both sides | $112.20 | $123.03 | $123.03 |
Where Pennsylvania sits
The same service costs 2.6 times more in Hawaii 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· 27th of 51
$70.79
HI $132DE $51.29
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.