How much rates vary
Facilitymedian $186 · 10th to 90th $170 to $1,259Professionalmedian $174 · 10th to 90th $129 to $355
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 $158.49 Median $158.49 Typical High $169.82 | Facility | None | $158.49 | $158.49 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $173.78 | Professional | None | $154.88 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $79.43 Typical High $87.10 | Professional | 52 · Reduced service | $77.62 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $31.62 Typical High $34.67 | Professional | 53 · Discontinued | $30.90 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $26.30 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $17.38 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $17.38 |
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 $288.40 Median $354.81 Typical High $354.81 | Professional | None | $288.40 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $181.97 | Facility | None | $173.78 | $173.78 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $1,621.81 | Professional | None | $128.82 | $128.82 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $478.63 | Professional | None | $263.03 | $416.87 | $478.63 |
Geisinger Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Geisinger Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $363.08 | Professional | None | $190.55 | $218.78 | $363.08 |
Martin's Point Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $173.78 | Professional | None | $154.88 | $158.49 | $173.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $79.43 Typical High $87.10 | Professional | 52 · Reduced service | $77.62 | $79.43 | $87.10 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $31.62 Typical High $34.67 | Professional | 53 · Discontinued | $30.90 | $31.62 | $34.67 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $26.30 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $26.30 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $17.38 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $17.38 |
Oscar Health Setting Professional Modifier None Typical Low $173.78 Median $398.11 Typical High $426.58 | Professional | None | $173.78 | $398.11 | $426.58 |
UPMC Health Plan Setting Facility Modifier None Typical Low $169.82 Median $776.25 Typical High $1,318.26 | Facility | None | $169.82 | $776.25 | $1,318.26 |
UPMC Health Plan Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $338.84 | Professional | None | $169.82 | $169.82 | $338.84 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $457.09 | Facility | None | $186.21 | $229.09 | $457.09 |
United Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $275.42 | Professional | None | $138.04 | $177.83 | $275.42 |
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 $323.59 Median $354.81 Typical High $354.81 | Professional | 50 · Both sides | $323.59 | $354.81 | $354.81 |
Where Pennsylvania sits
The same service costs 4.0 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· 39th of 51
$174
HI $525FL $132
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.