How much rates vary
Facilitymedian $34 · 10th to 90th $28 to $269Professionalmedian $28 · 10th to 90th $19 to $48
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 $19.50 Median $19.50 Typical High $21.88 | Facility | None | $19.50 | $19.50 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $21.88 Typical High $22.91 | Professional | None | $19.50 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.77 Median $10.96 Typical High $11.48 | Professional | 52 · Reduced service | $9.77 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.37 Typical High $4.57 | Professional | 53 · Discontinued | $3.98 | $4.37 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.24 Typical High $3.47 | Professional | 55 · Aftercare only | $2.95 | $3.24 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.19 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.95 | $2.19 | $2.29 |
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 $38.02 Median $47.86 Typical High $47.86 | Professional | None | $38.02 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $239.88 | Professional | None | $19.95 | $19.95 | $239.88 |
Emblem Health Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $81.28 | Professional | None | $44.67 | $70.79 | $81.28 |
Geisinger Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Geisinger Setting Professional Modifier None Typical Low $29.51 Median $33.88 Typical High $48.98 | Professional | None | $29.51 | $33.88 | $48.98 |
Martin's Point Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Martin's Point Setting Professional Modifier None Typical Low $19.50 Median $21.88 Typical High $22.91 | Professional | None | $19.50 | $21.88 | $22.91 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $9.77 Median $10.96 Typical High $11.48 | Professional | 52 · Reduced service | $9.77 | $10.96 | $11.48 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.37 Typical High $4.57 | Professional | 53 · Discontinued | $3.98 | $4.37 | $4.57 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.24 Typical High $3.47 | Professional | 55 · Aftercare only | $2.95 | $3.24 | $3.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.19 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.95 | $2.19 | $2.29 |
Oscar Health Setting Professional Modifier None Typical Low $43.65 Median $69.18 Typical High $72.44 | Professional | None | $43.65 | $69.18 | $72.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $33.88 Median $154.88 Typical High $269.15 | Facility | None | $33.88 | $154.88 | $269.15 |
UPMC Health Plan Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $45.71 | Professional | None | $33.88 | $33.88 | $45.71 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $70.79 | Facility | None | $60.26 | $60.26 | $70.79 |
United Setting Professional Modifier None Typical Low $18.62 Median $23.99 Typical High $36.31 | Professional | None | $18.62 | $23.99 | $36.31 |
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 $43.65 Median $47.86 Typical High $47.86 | Professional | 50 · Both sides | $43.65 | $47.86 | $47.86 |
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· 24th of 51
$27.54
MT $52.48DE $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.