How much rates vary
Facilitymedian $363 · 10th to 90th $245 to $1,950Professionalmedian $275 · 10th to 90th $245 to $550
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 $245.47 Median $245.47 Typical High $257.04 | Facility | None | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $269.15 | Professional | None | $245.47 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $125.89 Typical High $134.90 | Professional | 52 · Reduced service | $123.03 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $53.70 | Professional | 53 · Discontinued | $48.98 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $40.74 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $26.92 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $26.92 |
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 $446.68 Median $549.54 Typical High $549.54 | Professional | None | $446.68 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $2,754.23 | Professional | None | $269.15 | $269.15 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,096.48 | Professional | None | $602.56 | $954.99 | $1,096.48 |
Geisinger Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Geisinger Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $562.34 | Professional | None | $288.40 | $338.84 | $562.34 |
Martin's Point Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $269.15 | Professional | None | $245.47 | $257.04 | $269.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $128.82 Typical High $134.90 | Professional | 52 · Reduced service | $123.03 | $128.82 | $134.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $52.48 Typical High $53.70 | Professional | 53 · Discontinued | $48.98 | $52.48 | $53.70 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.90 Typical High $40.74 | Professional | 55 · Aftercare only | $37.15 | $38.90 | $40.74 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.70 Typical High $26.92 | Professional | 56 · Pre-op care only | $24.55 | $25.70 | $26.92 |
Oscar Health Setting Professional Modifier None Typical Low $398.11 Median $912.01 Typical High $977.24 | Professional | None | $398.11 | $912.01 | $977.24 |
UPMC Health Plan Setting Facility Modifier None Typical Low $263.03 Median $1,202.26 Typical High $2,041.74 | Facility | None | $263.03 | $1,202.26 | $2,041.74 |
UPMC Health Plan Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $524.81 | Professional | None | $263.03 | $263.03 | $524.81 |
United Setting Facility Modifier None Typical Low $239.88 Median $323.59 Typical High $794.33 | Facility | None | $239.88 | $323.59 | $794.33 |
United Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $457.09 | Professional | None | $239.88 | $275.42 | $457.09 |
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 $501.19 Median $549.54 Typical High $549.54 | Professional | 50 · Both sides | $501.19 | $549.54 | $549.54 |
Where Pennsylvania sits
The same service costs 2.6 times more in Hawaii than in Alabama. 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· 44th of 51
$275
HI $708AL $269
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.