How much rates vary
Facilitymedian $52 · 10th to 90th $44 to $380Professionalmedian $43 · 10th to 90th $31 to $74
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 $30.90 Median $37.15 Typical High $56.23 | Facility | None | $30.90 | $37.15 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $33.88 Typical High $41.69 | Professional | None | $30.90 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $16.98 Typical High $18.20 | Professional | 52 · Reduced service | $15.49 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.76 Typical High $7.24 | Professional | 53 · Discontinued | $6.17 | $6.76 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.13 Typical High $5.37 | Professional | 55 · Aftercare only | $4.57 | $5.13 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.39 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.09 | $3.39 | $3.63 |
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 $74.13 Typical High $74.13 | Professional | None | $60.26 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $69.18 | Facility | None | $46.77 | $46.77 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $371.54 | Professional | None | $33.88 | $33.88 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $70.79 Median $109.65 Typical High $128.82 | Professional | None | $70.79 | $109.65 | $128.82 |
Geisinger Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Geisinger Setting Professional Modifier None Typical Low $39.81 Median $45.71 Typical High $75.86 | Professional | None | $39.81 | $45.71 | $75.86 |
Highmark BCBS Setting Facility Modifier None Typical Low $19.05 Median $162.18 Typical High $323.59 | Facility | None | $19.05 | $162.18 | $323.59 |
Highmark BCBS Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $60.26 | Professional | None | $52.48 | $56.23 | $60.26 |
Martin's Point Setting Facility Modifier None Typical Low $30.90 Median $33.88 Typical High $66.07 | Facility | None | $30.90 | $33.88 | $66.07 |
Martin's Point Setting Professional Modifier None Typical Low $30.90 Median $33.88 Typical High $41.69 | Professional | None | $30.90 | $33.88 | $41.69 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $16.98 Typical High $18.20 | Professional | 52 · Reduced service | $15.49 | $16.98 | $18.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.76 Typical High $7.24 | Professional | 53 · Discontinued | $6.17 | $6.76 | $7.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.13 Typical High $5.37 | Professional | 55 · Aftercare only | $4.57 | $5.13 | $5.37 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.39 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.09 | $3.39 | $3.63 |
Oscar Health Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $107.15 | Professional | None | $24.55 | $24.55 | $107.15 |
UPMC Health Plan Setting Facility Modifier None Typical Low $51.29 Median $245.47 Typical High $416.87 | Facility | None | $51.29 | $245.47 | $416.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $107.15 | Facility | None | $43.65 | $43.65 | $107.15 |
United Setting Professional Modifier None Typical Low $29.51 Median $37.15 Typical High $60.26 | Professional | None | $29.51 | $37.15 | $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 $67.61 Median $74.13 Typical High $74.13 | Professional | 50 · Both sides | $67.61 | $74.13 | $74.13 |
Where Pennsylvania sits
The same service costs 3.1 times more in Hawaii than in Florida. 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
$44.67
HI $105FL $33.88
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.