How much rates vary
Facilitymedian $851 · 10th to 90th $741 to $5,012Professionalmedian $646 · 10th to 90th $490 to $1,175
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 $489.78 Median $489.78 Typical High $537.03 | Facility | None | $489.78 | $489.78 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $562.34 | Professional | None | $489.78 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $269.15 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $56.23 |
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 $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | None | $954.99 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $6,606.93 | Professional | None | $537.03 | $537.03 | $6,606.93 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,348.96 | $2,137.96 | $2,511.89 |
Geisinger Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Geisinger Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,202.26 | Professional | None | $616.60 | $724.44 | $1,202.26 |
Highmark BCBS Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,318.26 | Professional | None | $831.76 | $891.25 | $1,318.26 |
Martin's Point Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $562.34 | Professional | None | $489.78 | $537.03 | $562.34 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $269.15 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $269.15 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $107.15 | $112.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $85.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $56.23 |
Oscar Health Setting Professional Modifier None Typical Low $891.25 Median $2,089.30 Typical High $2,187.76 | Professional | None | $891.25 | $2,089.30 | $2,187.76 |
UPMC Health Plan Setting Facility Modifier None Typical Low $851.14 Median $3,801.89 Typical High $6,606.93 | Facility | None | $851.14 | $3,801.89 | $6,606.93 |
UPMC Health Plan Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,122.02 | Professional | None | $851.14 | $851.14 | $1,122.02 |
United Setting Facility Modifier None Typical Low $776.25 Median $912.01 Typical High $1,905.46 | Facility | None | $776.25 | $912.01 | $1,905.46 |
United Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $977.24 | Professional | None | $478.63 | $588.84 | $977.24 |
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 $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 50 · Both sides | $1,071.52 | $1,174.90 | $1,174.90 |
Where Pennsylvania sits
The same service costs 4.6 times more in Hawaii 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· 37th of 51
$724
HI $2,455DE $537
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.