How much rates vary
Facilitymedian $52 · 10th to 90th $42 to $407Professionalmedian $40 · 10th to 90th $30 to $72
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 $30.20 Median $30.20 Typical High $33.11 | Facility | None | $30.20 | $30.20 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $35.48 | Professional | None | $30.20 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $16.60 Typical High $17.78 | Professional | 52 · Reduced service | $15.14 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.61 Typical High $7.08 | Professional | 53 · Discontinued | $6.03 | $6.61 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.01 Typical High $5.25 | Professional | 55 · Aftercare only | $4.47 | $5.01 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.31 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.02 | $3.31 | $3.55 |
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 $60.26 Median $72.44 Typical High $72.44 | Professional | None | $60.26 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $363.08 | Professional | None | $30.90 | $30.90 | $363.08 |
Emblem Health Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $125.89 | Professional | None | $69.18 | $107.15 | $125.89 |
Geisinger Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Geisinger Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $74.13 | Professional | None | $44.67 | $52.48 | $74.13 |
Martin's Point Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Martin's Point Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $35.48 | Professional | None | $30.20 | $33.11 | $35.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $16.60 Typical High $17.78 | Professional | 52 · Reduced service | $15.14 | $16.60 | $17.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.61 Typical High $7.08 | Professional | 53 · Discontinued | $6.03 | $6.61 | $7.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.01 Typical High $5.25 | Professional | 55 · Aftercare only | $4.47 | $5.01 | $5.25 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.31 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.02 | $3.31 | $3.55 |
Oscar Health Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $109.65 | Professional | None | $74.13 | $104.71 | $109.65 |
UPMC Health Plan Setting Facility Modifier None Typical Low $52.48 Median $239.88 Typical High $407.38 | Facility | None | $52.48 | $239.88 | $407.38 |
UPMC Health Plan Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $69.18 | Professional | None | $52.48 | $52.48 | $69.18 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Facility | None | $91.20 | $91.20 | $109.65 |
United Setting Professional Modifier None Typical Low $28.84 Median $36.31 Typical High $60.26 | Professional | None | $28.84 | $36.31 | $60.26 |
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 $66.07 Median $72.44 Typical High $72.44 | Professional | 50 · Both sides | $66.07 | $72.44 | $72.44 |
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
$41.69
MT $79.43DE $30.90
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.