How much rates vary
Facilitymedian $389 · 10th to 90th $282 to $2,239Professionalmedian $309 · 10th to 90th $275 to $617
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 $275.42 Median $275.42 Typical High $295.12 | Facility | None | $275.42 | $275.42 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $309.03 | Professional | None | $275.42 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $147.91 Typical High $151.36 | Professional | 52 · Reduced service | $138.04 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $61.66 | Professional | 53 · Discontinued | $54.95 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $45.71 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $30.90 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $30.90 |
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 $512.86 Median $616.60 Typical High $616.60 | Professional | None | $512.86 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $3,388.44 | Professional | None | $281.84 | $281.84 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,071.52 | Professional | None | $588.84 | $912.01 | $1,071.52 |
Geisinger Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Geisinger Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $630.96 | Professional | None | $331.13 | $380.19 | $630.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $630.96 | Professional | None | $436.52 | $467.74 | $630.96 |
Martin's Point Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Martin's Point Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $309.03 | Professional | None | $275.42 | $295.12 | $309.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $147.91 Typical High $151.36 | Professional | 52 · Reduced service | $138.04 | $147.91 | $151.36 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $61.66 | Professional | 53 · Discontinued | $56.23 | $58.88 | $61.66 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $44.67 Typical High $45.71 | Professional | 55 · Aftercare only | $41.69 | $44.67 | $45.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $30.90 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $30.90 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $891.25 Typical High $933.25 | Professional | None | $389.05 | $891.25 | $933.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $295.12 Median $1,348.96 Typical High $2,344.23 | Facility | None | $295.12 | $1,348.96 | $2,344.23 |
UPMC Health Plan Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $588.84 | Professional | None | $295.12 | $295.12 | $588.84 |
United Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $1,023.29 | Facility | None | $281.84 | $331.13 | $1,023.29 |
United Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $512.86 | Professional | None | $281.84 | $316.23 | $512.86 |
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 $562.34 Median $616.60 Typical High $616.60 | Professional | 50 · Both sides | $562.34 | $616.60 | $616.60 |
Where Pennsylvania sits
The same service costs 2.6 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· 49th of 51
$309
HI $724DE $282
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.