How much rates vary
Facilitymedian $490 · 10th to 90th $380 to $2,818Professionalmedian $398 · 10th to 90th $324 to $794
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 $323.59 Median $323.59 Typical High $363.08 | Facility | None | $323.59 | $323.59 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $380.19 | Professional | None | $323.59 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $72.44 Typical High $75.86 | Professional | 53 · Discontinued | $64.57 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $36.31 | $38.02 |
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 $645.65 Median $794.33 Typical High $794.33 | Professional | None | $645.65 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $4,365.16 | Professional | None | $363.08 | $363.08 | $4,365.16 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $1,348.96 | Professional | None | $741.31 | $1,174.90 | $1,348.96 |
Geisinger Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Geisinger Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $812.83 | Professional | None | $416.87 | $478.63 | $812.83 |
Martin's Point Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $380.19 | Professional | None | $323.59 | $363.08 | $380.19 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $181.97 | $190.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $72.44 Typical High $75.86 | Professional | 53 · Discontinued | $64.57 | $72.44 | $75.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $57.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $36.31 | $38.02 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $1,122.02 Typical High $1,202.26 | Professional | None | $489.78 | $1,122.02 | $1,202.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $380.19 Median $1,737.80 Typical High $2,951.21 | Facility | None | $380.19 | $1,737.80 | $2,951.21 |
UPMC Health Plan Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $758.58 | Professional | None | $380.19 | $380.19 | $758.58 |
United Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $1,288.25 | Facility | None | $478.63 | $524.81 | $1,288.25 |
United Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $660.69 | Professional | None | $323.59 | $398.11 | $660.69 |
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 $707.95 Median $794.33 Typical High $794.33 | Professional | 50 · Both sides | $707.95 | $794.33 | $794.33 |
Where Pennsylvania sits
The same service costs 3.2 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· 50th of 51
$398
HI $1,175DE $363
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.