How much rates vary
Facilitymedian $81 · 10th to 90th $65 to $631Professionalmedian $65 · 10th to 90th $47 to $112
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 $46.77 Median $46.77 Typical High $51.29 | Facility | None | $46.77 | $46.77 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $54.95 | Professional | None | $46.77 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $25.70 Typical High $27.54 | Professional | 52 · Reduced service | $23.44 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.23 Typical High $10.96 | Professional | 53 · Discontinued | $9.33 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.76 Typical High $8.13 | Professional | 55 · Aftercare only | $6.92 | $7.76 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.13 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.68 | $5.13 | $5.50 |
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 $91.20 Median $112.20 Typical High $112.20 | Professional | None | $91.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $562.34 | Professional | None | $46.77 | $46.77 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $194.98 | Professional | None | $107.15 | $165.96 | $194.98 |
Geisinger Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Geisinger Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $114.82 | Professional | None | $60.26 | $69.18 | $114.82 |
Highmark BCBS Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | None | $85.11 | $93.33 | $93.33 |
Martin's Point Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Martin's Point Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $54.95 | Professional | None | $46.77 | $51.29 | $54.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $25.70 Typical High $27.54 | Professional | 52 · Reduced service | $23.44 | $25.70 | $27.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.23 Typical High $10.96 | Professional | 53 · Discontinued | $9.33 | $10.23 | $10.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.76 Typical High $8.13 | Professional | 55 · Aftercare only | $6.92 | $7.76 | $8.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.13 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.68 | $5.13 | $5.50 |
Oscar Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $162.18 | Professional | None | $38.02 | $38.02 | $162.18 |
UPMC Health Plan Setting Facility Modifier None Typical Low $81.28 Median $371.54 Typical High $630.96 | Facility | None | $81.28 | $371.54 | $630.96 |
UPMC Health Plan Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $107.15 | Professional | None | $81.28 | $81.28 | $107.15 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Facility | None | $141.25 | $141.25 | $169.82 |
United Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $85.11 | Professional | None | $44.67 | $56.23 | $85.11 |
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 $102.33 Median $112.20 Typical High $112.20 | Professional | 50 · Both sides | $102.33 | $112.20 | $112.20 |
Where Pennsylvania sits
The same service costs 2.6 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· 31st of 51
$64.57
HI $120DE $46.77
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.