How much rates vary
Facilitymedian $263 · 10th to 90th $191 to $1,445Professionalmedian $200 · 10th to 90th $182 to $407
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 $181.97 Median $181.97 Typical High $190.55 | Facility | None | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $199.53 | Professional | None | $177.83 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $95.50 Typical High $100.00 | Professional | 52 · Reduced service | $89.13 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $39.81 | Professional | 53 · Discontinued | $35.48 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $29.51 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.05 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.78 | $19.05 | $19.95 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $323.59 Median $407.38 Typical High $407.38 | Professional | None | $323.59 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $2,398.83 | Professional | None | $190.55 | $190.55 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $691.83 | Professional | None | $380.19 | $588.84 | $691.83 |
Geisinger Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Geisinger Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $407.38 | Professional | None | $213.80 | $245.47 | $407.38 |
Highmark BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Martin's Point Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $199.53 | Professional | None | $177.83 | $190.55 | $199.53 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $95.50 Typical High $100.00 | Professional | 52 · Reduced service | $89.13 | $95.50 | $100.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $39.81 | Professional | 53 · Discontinued | $36.31 | $38.02 | $39.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.84 Typical High $29.51 | Professional | 55 · Aftercare only | $26.92 | $28.84 | $29.51 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $19.95 |
Oscar Health Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $616.60 | Professional | None | $251.19 | $416.87 | $616.60 |
UPMC Health Plan Setting Facility Modifier None Typical Low $190.55 Median $870.96 Typical High $1,513.56 | Facility | None | $190.55 | $870.96 | $1,513.56 |
UPMC Health Plan Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $380.19 | Professional | None | $190.55 | $190.55 | $380.19 |
United Setting Facility Modifier None Typical Low $263.03 Median $549.54 Typical High $660.69 | Facility | None | $263.03 | $549.54 | $660.69 |
United Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $338.84 | Professional | None | $181.97 | $204.17 | $338.84 |
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 $363.08 Median $407.38 Typical High $407.38 | Professional | 50 · Both sides | $363.08 | $407.38 | $407.38 |
Where Pennsylvania sits
The same service costs 3.0 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
$200
HI $562DE $191
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.