How much rates vary
Facilitymedian $45 · 10th to 90th $36 to $275Professionalmedian $39 · 10th to 90th $33 to $78
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 $34.67 Median $34.67 Typical High $37.15 | Facility | None | $34.67 | $34.67 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $34.67 Typical High $38.02 | Professional | None | $33.88 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $17.38 Typical High $19.05 | Professional | 52 · Reduced service | $16.98 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.92 Typical High $7.59 | Professional | 53 · Discontinued | $6.76 | $6.92 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.25 Typical High $5.75 | Professional | 55 · Aftercare only | $5.13 | $5.25 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.47 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.39 | $3.47 | $3.80 |
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 $61.66 Median $77.62 Typical High $77.62 | Professional | None | $61.66 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $346.74 | Professional | None | $33.11 | $33.11 | $346.74 |
Emblem Health Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $141.25 | Professional | None | $75.86 | $120.23 | $141.25 |
Geisinger Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Geisinger Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $79.43 | Professional | None | $40.74 | $47.86 | $79.43 |
Martin's Point Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Martin's Point Setting Professional Modifier None Typical Low $33.88 Median $34.67 Typical High $38.02 | Professional | None | $33.88 | $34.67 | $38.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $17.38 Typical High $19.05 | Professional | 52 · Reduced service | $16.98 | $17.38 | $19.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.92 Typical High $7.59 | Professional | 53 · Discontinued | $6.76 | $6.92 | $7.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.25 Typical High $5.75 | Professional | 55 · Aftercare only | $5.13 | $5.25 | $5.75 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.47 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.39 | $3.47 | $3.80 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $123.03 | Professional | None | $50.12 | $85.11 | $123.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $37.15 Median $169.82 Typical High $288.40 | Facility | None | $37.15 | $169.82 | $288.40 |
UPMC Health Plan Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $74.13 | Professional | None | $37.15 | $37.15 | $74.13 |
United Setting Facility Modifier None Typical Low $36.31 Median $37.15 Typical High $100.00 | Facility | None | $36.31 | $37.15 | $100.00 |
United Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $61.66 | Professional | None | $30.90 | $38.90 | $61.66 |
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 $70.79 Median $77.62 Typical High $77.62 | Professional | 50 · Both sides | $70.79 | $77.62 | $77.62 |
Where Pennsylvania sits
The same service costs 2.5 times more in Hawaii than in Florida. 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· 36th of 51
$38.90
HI $81.28FL $33.11
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.