How much rates vary
Facilitymedian $65 · 10th to 90th $51 to $501Professionalmedian $49 · 10th to 90th $37 to $89
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 $37.15 Median $37.15 Typical High $40.74 | Facility | None | $37.15 | $37.15 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $43.65 | Professional | None | $37.15 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $20.42 Typical High $21.38 | Professional | 52 · Reduced service | $18.62 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.13 Typical High $8.71 | Professional | 53 · Discontinued | $7.41 | $8.13 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.17 Typical High $6.46 | Professional | 55 · Aftercare only | $5.50 | $6.17 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.07 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.72 | $4.07 | $4.37 |
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 $72.44 Median $89.13 Typical High $89.13 | Professional | None | $72.44 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $446.68 | Professional | None | $37.15 | $37.15 | $446.68 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $154.88 | Professional | None | $85.11 | $131.83 | $154.88 |
Geisinger Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Geisinger Setting Professional Modifier None Typical Low $54.95 Median $58.88 Typical High $91.20 | Professional | None | $54.95 | $58.88 | $91.20 |
Martin's Point Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Martin's Point Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $43.65 | Professional | None | $37.15 | $40.74 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $20.42 Typical High $21.38 | Professional | 52 · Reduced service | $18.62 | $20.42 | $21.38 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.13 Typical High $8.71 | Professional | 53 · Discontinued | $7.41 | $8.13 | $8.71 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.17 Typical High $6.46 | Professional | 55 · Aftercare only | $5.50 | $6.17 | $6.46 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.07 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.72 | $4.07 | $4.37 |
Oscar Health Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $134.90 | Professional | None | $91.20 | $128.82 | $134.90 |
UPMC Health Plan Setting Facility Modifier None Typical Low $64.57 Median $295.12 Typical High $501.19 | Facility | None | $64.57 | $295.12 | $501.19 |
UPMC Health Plan Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $85.11 | Professional | None | $64.57 | $64.57 | $85.11 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $134.90 | Facility | None | $112.20 | $112.20 | $134.90 |
United Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $74.13 | Professional | None | $34.67 | $44.67 | $74.13 |
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 $81.28 Median $89.13 Typical High $89.13 | Professional | 50 · Both sides | $81.28 | $89.13 | $89.13 |
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· 26th of 51
$51.29
MT $97.72DE $37.15
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.