How much rates vary
Facilitymedian $148 · 10th to 90th $120 to $891Professionalmedian $126 · 10th to 90th $102 to $251
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 $112.20 Median $112.20 Typical High $117.49 | Facility | None | $112.20 | $112.20 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $123.03 | Professional | None | $109.65 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $56.23 Typical High $61.66 | Professional | 52 · Reduced service | $54.95 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $24.55 | Professional | 53 · Discontinued | $21.88 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $16.22 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.96 | $11.22 | $12.30 |
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 $204.17 Median $251.19 Typical High $251.19 | Professional | None | $204.17 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $1,230.27 | Professional | None | $102.33 | $102.33 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $416.87 | Professional | None | $223.87 | $354.81 | $416.87 |
Geisinger Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Geisinger Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $257.04 | Professional | None | $131.83 | $151.36 | $257.04 |
Martin's Point Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $123.03 | Professional | None | $109.65 | $117.49 | $123.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $58.88 Typical High $61.66 | Professional | 52 · Reduced service | $54.95 | $58.88 | $61.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $24.55 | Professional | 53 · Discontinued | $21.88 | $23.44 | $24.55 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.78 Typical High $18.20 | Professional | 55 · Aftercare only | $16.22 | $17.78 | $18.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.96 | $11.75 | $12.30 |
Oscar Health Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $363.08 | Professional | None | $147.91 | $251.19 | $363.08 |
UPMC Health Plan Setting Facility Modifier None Typical Low $120.23 Median $537.03 Typical High $933.25 | Facility | None | $120.23 | $537.03 | $933.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $239.88 | Professional | None | $120.23 | $120.23 | $239.88 |
United Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $363.08 | Facility | None | $147.91 | $154.88 | $363.08 |
United Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $208.93 | Professional | None | $109.65 | $125.89 | $208.93 |
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 $223.87 Median $251.19 Typical High $251.19 | Professional | 50 · Both sides | $223.87 | $251.19 | $251.19 |
Where Pennsylvania sits
The same service costs 3.5 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
$126
HI $363DE $102
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.