How much rates vary
Facilitymedian $1,585 · 10th to 90th $871 to $5,248Professionalmedian $1,148 · 10th to 90th $871 to $1,950
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 $870.96 Median $870.96 Typical High $912.01 | Facility | None | $870.96 | $870.96 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $954.99 | Professional | None | $851.14 | $891.25 | $954.99 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $446.68 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $95.50 |
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 $1,584.89 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,584.89 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $10,232.93 | Professional | None | $1,148.15 | $1,148.15 | $10,232.93 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,754.23 Typical High $3,235.94 | Professional | None | $1,778.28 | $2,754.23 | $3,235.94 |
Geisinger Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Geisinger Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,174.90 | $1,995.26 |
Martin's Point Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Martin's Point Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $954.99 | Professional | None | $851.14 | $912.01 | $954.99 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $457.09 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $457.09 | $478.63 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $181.97 | $190.55 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $141.25 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $95.50 |
Oscar Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,949.84 | $2,818.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $933.25 Median $4,168.69 Typical High $7,244.36 | Facility | None | $933.25 | $4,168.69 | $7,244.36 |
UPMC Health Plan Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,862.09 | Professional | None | $933.25 | $933.25 | $1,862.09 |
United Setting Facility Modifier None Typical Low $794.33 Median $1,071.52 Typical High $3,090.30 | Facility | None | $794.33 | $1,071.52 | $3,090.30 |
United Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,621.81 | Professional | None | $870.96 | $977.24 | $1,621.81 |
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 $1,737.80 Median $1,949.84 Typical High $1,949.84 | Professional | 50 · Both sides | $1,737.80 | $1,949.84 | $1,949.84 |
Where Pennsylvania sits
The same service costs 2.3 times more in Wisconsin than in Washington, DC. 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
$1,148
WI $2,455DC $1,047
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.