How much rates vary
Facilitymedian $29 · 10th to 90th $23 to $224Professionalmedian $22 · 10th to 90th $17 to $41
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 $16.60 Median $16.60 Typical High $18.20 | Facility | None | $16.60 | $16.60 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $18.20 Typical High $19.50 | Professional | None | $16.60 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $9.12 Typical High $9.77 | Professional | 52 · Reduced service | $8.32 | $9.12 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.63 Typical High $3.89 | Professional | 53 · Discontinued | $3.31 | $3.63 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.75 Typical High $2.88 | Professional | 55 · Aftercare only | $2.51 | $2.75 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.82 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.66 | $1.82 | $1.95 |
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 $33.11 Median $40.74 Typical High $40.74 | Professional | None | $33.11 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $204.17 | Professional | None | $16.98 | $16.98 | $204.17 |
Emblem Health Setting Professional Modifier None Typical Low $38.02 Median $60.26 Typical High $69.18 | Professional | None | $38.02 | $60.26 | $69.18 |
Geisinger Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Geisinger Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $40.74 | Professional | None | $24.55 | $28.84 | $40.74 |
Martin's Point Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Martin's Point Setting Professional Modifier None Typical Low $16.60 Median $18.20 Typical High $19.50 | Professional | None | $16.60 | $18.20 | $19.50 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $9.12 Typical High $9.77 | Professional | 52 · Reduced service | $8.32 | $9.12 | $9.77 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.63 Typical High $3.89 | Professional | 53 · Discontinued | $3.31 | $3.63 | $3.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.75 Typical High $2.88 | Professional | 55 · Aftercare only | $2.51 | $2.75 | $2.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.82 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.66 | $1.82 | $1.95 |
Oscar Health Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $57.54 | Professional | None | $16.22 | $16.22 | $57.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $28.84 Median $131.83 Typical High $223.87 | Facility | None | $28.84 | $131.83 | $223.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.02 | Professional | None | $28.84 | $28.84 | $38.02 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Facility | None | $50.12 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $33.88 | Professional | None | $15.85 | $19.95 | $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 $36.31 Median $40.74 Typical High $40.74 | Professional | 50 · Both sides | $36.31 | $40.74 | $40.74 |
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· 31st of 51
$22.91
MT $43.65DE $16.98
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.