How much rates vary
Facilitymedian $1,585 · 10th to 90th $1,096 to $6,166Professionalmedian $1,175 · 10th to 90th $1,023 to $2,291
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 $1,023.29 Median $1,023.29 Typical High $1,071.52 | Facility | None | $1,023.29 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,122.02 | Professional | None | $1,000.00 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $524.81 Typical High $562.34 | Professional | 52 · Reduced service | $501.19 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $223.87 | Professional | 53 · Discontinued | $199.53 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $112.20 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $112.20 |
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 $1,862.09 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,862.09 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $12,302.69 | Professional | None | $1,174.90 | $1,174.90 | $12,302.69 |
Emblem Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,235.94 Typical High $3,715.35 | Professional | None | $2,041.74 | $3,235.94 | $3,715.35 |
Geisinger Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Geisinger Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,380.38 | $2,344.23 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Martin's Point Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,122.02 | Professional | None | $1,000.00 | $1,071.52 | $1,122.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $537.03 Typical High $562.34 | Professional | 52 · Reduced service | $501.19 | $537.03 | $562.34 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $223.87 | Professional | 53 · Discontinued | $199.53 | $213.80 | $223.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $165.96 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $112.20 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $112.20 |
Oscar Health Setting Professional Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $3,311.31 | Professional | None | $1,348.96 | $3,090.30 | $3,311.31 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,096.48 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,096.48 | $4,897.79 | $8,511.38 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,096.48 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $3,548.13 | Facility | None | $1,258.93 | $1,445.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,122.02 | $1,905.46 |
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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,290.87 Typical High $2,290.87 | Professional | 50 · Both sides | $2,041.74 | $2,290.87 | $2,290.87 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $1,584.89 Median $1,698.24 Typical High $1,698.24 | Professional | KX · Policy requirements met | $1,584.89 | $1,698.24 | $1,698.24 |
Where Pennsylvania sits
The same service costs 2.7 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· 48th of 51
$1,175
HI $3,162DE $1,175
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.