How much rates vary
Facilitymedian $126 · 10th to 90th $107 to $417Professionalmedian $123 · 10th to 90th $81 to $200
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 $81.28 Median $81.28 Typical High $89.13 | Facility | None | $81.28 | $81.28 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $128.82 | Professional | None | $81.28 | $89.13 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $44.67 Typical High $47.86 | Professional | 52 · Reduced service | $40.74 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $17.78 Typical High $19.05 | Professional | 53 · Discontinued | $16.22 | $17.78 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.49 Typical High $14.13 | Professional | 55 · Aftercare only | $12.30 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.91 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.13 | $8.91 | $9.55 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
AmeriHealth Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | None | $123.03 | $147.91 | $147.91 |
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 $158.49 Median $199.53 Typical High $199.53 | Professional | None | $158.49 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Facility | None | $107.15 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $977.24 | Professional | None | $93.33 | $93.33 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $338.84 | Professional | None | $186.21 | $288.40 | $338.84 |
Geisinger Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Geisinger Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $199.53 | Professional | None | $120.23 | $123.03 | $199.53 |
Highmark BCBS Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $194.98 | Professional | None | $138.04 | $158.49 | $194.98 |
Independence Blue Cross Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $147.91 | Professional | None | $97.72 | $123.03 | $147.91 |
Martin's Point Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Martin's Point Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $123.03 | Professional | None | $81.28 | $89.13 | $123.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $44.67 Typical High $47.86 | Professional | 52 · Reduced service | $40.74 | $44.67 | $47.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $17.78 Typical High $19.05 | Professional | 53 · Discontinued | $16.22 | $17.78 | $19.05 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.49 Typical High $14.13 | Professional | 55 · Aftercare only | $12.30 | $13.49 | $14.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.91 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.13 | $8.91 | $9.55 |
Oscar Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $204.17 | Professional | None | $77.62 | $77.62 | $204.17 |
UPMC Health Plan Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $186.21 | Facility | None | $144.54 | $144.54 | $186.21 |
UPMC Health Plan Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | None | $144.54 | $144.54 | $186.21 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $295.12 | Facility | None | $245.47 | $245.47 | $295.12 |
United Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $158.49 | Professional | None | $77.62 | $97.72 | $158.49 |
2 more rates 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 |
|---|---|---|---|---|---|
Cigna Setting Facility Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | RR · Rental | $12.59 | $12.59 | $12.59 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Where Pennsylvania sits
The same service costs 2.1 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· 27th of 51
$126
HI $200DE $93.33
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.