How much rates vary
Facilitymedian $339 · 10th to 90th $251 to $1,862Professionalmedian $263 · 10th to 90th $234 to $525
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 $234.42 Median $234.42 Typical High $245.47 | Facility | None | $234.42 | $234.42 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $257.04 | Professional | None | $229.09 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $123.03 Typical High $128.82 | Professional | 52 · Reduced service | $114.82 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $48.98 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $34.67 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $25.70 |
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 $426.58 Median $524.81 Typical High $524.81 | Professional | None | $426.58 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $2,818.38 | Professional | None | $245.47 | $245.47 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $891.25 | Professional | None | $489.78 | $776.25 | $891.25 |
Geisinger Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Geisinger Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $537.03 | Professional | None | $275.42 | $323.59 | $537.03 |
Highmark BCBS Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Martin's Point Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Martin's Point Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $257.04 | Professional | None | $229.09 | $245.47 | $257.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $123.03 Typical High $128.82 | Professional | 52 · Reduced service | $117.49 | $123.03 | $128.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $51.29 | Professional | 53 · Discontinued | $46.77 | $48.98 | $51.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $38.90 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $38.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $25.70 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $25.70 |
Oscar Health Setting Professional Modifier None Typical Low $323.59 Median $741.31 Typical High $794.33 | Professional | None | $323.59 | $741.31 | $794.33 |
UPMC Health Plan Setting Facility Modifier None Typical Low $251.19 Median $1,148.15 Typical High $1,949.84 | Facility | None | $251.19 | $1,148.15 | $1,949.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $501.19 | Professional | None | $251.19 | $251.19 | $501.19 |
United Setting Facility Modifier None Typical Low $263.03 Median $363.08 Typical High $851.14 | Facility | None | $263.03 | $363.08 | $851.14 |
United Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $436.52 | Professional | None | $234.42 | $263.03 | $436.52 |
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 $467.74 Median $524.81 Typical High $524.81 | Professional | 50 · Both sides | $467.74 | $524.81 | $524.81 |
Where Pennsylvania sits
The same service costs 2.8 times more in Wyoming 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
$263
WY $676DE $245
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.