How much rates vary
Facilitymedian $182 · 10th to 90th $107 to $794Professionalmedian $132 · 10th to 90th $100 to $224
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 $100.00 Median $100.00 Typical High $104.71 | Facility | None | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $109.65 | Professional | None | $100.00 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $52.48 Typical High $54.95 | Professional | 52 · Reduced service | $50.12 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.89 Typical High $21.88 | Professional | 53 · Discontinued | $19.95 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.85 Typical High $16.22 | Professional | 55 · Aftercare only | $14.79 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $10.96 |
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 $181.97 Median $223.87 Typical High $223.87 | Professional | None | $181.97 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $1,230.27 | Professional | None | $131.83 | $131.83 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $512.86 | Professional | None | $275.42 | $436.52 | $512.86 |
Geisinger Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Geisinger Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $229.09 | Professional | None | $117.49 | $134.90 | $229.09 |
Martin's Point Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Martin's Point Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $109.65 | Professional | None | $100.00 | $104.71 | $109.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $52.48 Typical High $54.95 | Professional | 52 · Reduced service | $50.12 | $52.48 | $54.95 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.89 Typical High $21.88 | Professional | 53 · Discontinued | $19.95 | $20.89 | $21.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.85 Typical High $16.22 | Professional | 55 · Aftercare only | $14.79 | $15.85 | $16.22 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $10.96 |
Oscar Health Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $446.68 | Professional | None | $181.97 | $309.03 | $446.68 |
UPMC Health Plan Setting Facility Modifier None Typical Low $107.15 Median $478.63 Typical High $831.76 | Facility | None | $107.15 | $478.63 | $831.76 |
UPMC Health Plan Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $213.80 | Professional | None | $107.15 | $107.15 | $213.80 |
United Setting Facility Modifier None Typical Low $147.91 Median $173.78 Typical High $363.08 | Facility | None | $147.91 | $173.78 | $363.08 |
United Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $186.21 | Professional | None | $100.00 | $112.20 | $186.21 |
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 $199.53 Median $223.87 Typical High $223.87 | Professional | 50 · Both sides | $199.53 | $223.87 | $223.87 |
Where Pennsylvania sits
The same service costs 3.5 times more in Hawaii 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· 41st of 51
$132
HI $427DC $120
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.