How much rates vary
Facilitymedian $282 · 10th to 90th $209 to $1,549Professionalmedian $219 · 10th to 90th $195 to $437
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 $194.98 Median $194.98 Typical High $204.17 | Facility | None | $194.98 | $194.98 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $213.80 | Professional | None | $190.55 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $102.33 Typical High $107.15 | Professional | 52 · Reduced service | $95.50 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $40.74 Typical High $42.66 | Professional | 53 · Discontinued | $38.02 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.20 Typical High $32.36 | Professional | 55 · Aftercare only | $28.84 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.42 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.05 | $20.42 | $21.38 |
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 $354.81 Median $436.52 Typical High $436.52 | Professional | None | $354.81 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $2,454.71 | Professional | None | $199.53 | $199.53 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $741.31 | Professional | None | $407.38 | $645.65 | $741.31 |
Geisinger Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Geisinger Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $446.68 | Professional | None | $229.09 | $269.15 | $446.68 |
Highmark BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Martin's Point Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Martin's Point Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $213.80 | Professional | None | $194.98 | $204.17 | $213.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $102.33 Typical High $107.15 | Professional | 52 · Reduced service | $97.72 | $102.33 | $107.15 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | 53 · Discontinued | $38.90 | $40.74 | $42.66 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.90 Typical High $32.36 | Professional | 55 · Aftercare only | $28.84 | $30.90 | $32.36 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.42 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.50 | $20.42 | $21.38 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $660.69 | Professional | None | $269.15 | $457.09 | $660.69 |
UPMC Health Plan Setting Facility Modifier None Typical Low $208.93 Median $954.99 Typical High $1,621.81 | Facility | None | $208.93 | $954.99 | $1,621.81 |
UPMC Health Plan Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $416.87 | Professional | None | $208.93 | $208.93 | $416.87 |
United Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $707.95 | Facility | None | $281.84 | $288.40 | $707.95 |
United Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $363.08 | Professional | None | $194.98 | $218.78 | $363.08 |
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 $389.05 Median $436.52 Typical High $436.52 | Professional | 50 · Both sides | $389.05 | $436.52 | $436.52 |
Where Pennsylvania sits
The same service costs 3.3 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
$219
HI $661DE $200
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.