How much rates vary
Facilitymedian $145 · 10th to 90th $141 to $562Professionalmedian $170 · 10th to 90th $105 to $269
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 $109.65 Median $123.03 Typical High $199.53 | Facility | None | $109.65 | $123.03 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $177.83 | Professional | None | $109.65 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $60.26 Typical High $64.57 | Professional | 52 · Reduced service | $54.95 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $21.88 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $18.20 Typical High $19.50 | Professional | 55 · Aftercare only | $16.60 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.30 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.96 | $12.30 | $12.88 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $275.42 | Professional | None | $158.49 | $204.17 | $275.42 |
AmeriHealth Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $199.53 | Professional | None | $165.96 | $199.53 | $199.53 |
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 $213.80 Median $269.15 Typical High $269.15 | Professional | None | $213.80 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | None | $141.25 | $141.25 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $1,348.96 | Professional | None | $104.71 | $104.71 | $1,348.96 |
Emblem Health Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $457.09 | Professional | None | $251.19 | $398.11 | $457.09 |
Geisinger Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Geisinger Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $275.42 | Professional | None | $162.18 | $165.96 | $275.42 |
Highmark BCBS Setting Facility Modifier None Typical Low $10.47 Median $37.15 Typical High $52.48 | Facility | None | $10.47 | $37.15 | $52.48 |
Highmark BCBS Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $245.47 | Professional | None | $186.21 | $213.80 | $245.47 |
Independence Blue Cross Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | None | $165.96 | $165.96 | $199.53 |
Martin's Point Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $204.17 | Facility | None | $109.65 | $109.65 | $204.17 |
Martin's Point Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $177.83 | Professional | None | $109.65 | $123.03 | $177.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $60.26 Typical High $64.57 | Professional | 52 · Reduced service | $54.95 | $60.26 | $64.57 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $21.88 | $24.55 | $25.70 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $18.20 Typical High $19.50 | Professional | 55 · Aftercare only | $16.60 | $18.20 | $19.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.30 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.96 | $12.30 | $12.88 |
Oscar Health Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Facility | None | $954.99 | $954.99 | $1,096.48 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $275.42 | Professional | None | $104.71 | $107.15 | $275.42 |
UPMC Health Plan Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $257.04 | Facility | None | $194.98 | $194.98 | $257.04 |
UPMC Health Plan Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $257.04 | Professional | None | $194.98 | $194.98 | $257.04 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $398.11 | Facility | None | $331.13 | $331.13 | $398.11 |
United Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $208.93 | Professional | None | $104.71 | $134.90 | $208.93 |
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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $186.21 Median $199.53 Typical High $213.80 | Professional | KX · Policy requirements met | $186.21 | $199.53 | $213.80 |
Where Pennsylvania sits
The same service costs 2.2 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· 29th of 51
$170
HI $275DE $126
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.