How much rates vary
Facilitymedian $174 · 10th to 90th $110 to $871Professionalmedian $129 · 10th to 90th $110 to $245
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 $109.65 Median $109.65 Typical High $117.49 | Facility | None | $109.65 | $109.65 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $120.23 | Professional | None | $107.15 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $54.95 Typical High $60.26 | Professional | 52 · Reduced service | $53.70 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $23.99 | Professional | 53 · Discontinued | $21.38 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $16.22 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $12.02 |
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 $199.53 Median $245.47 Typical High $245.47 | Professional | None | $199.53 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $1,148.15 | Professional | None | $128.82 | $128.82 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $380.19 | Professional | None | $208.93 | $323.59 | $380.19 |
Geisinger Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Geisinger Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $251.19 | Professional | None | $128.82 | $151.36 | $251.19 |
Highmark BCBS Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | None | $173.78 | $186.21 | $186.21 |
Martin's Point Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Martin's Point Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $120.23 | Professional | None | $107.15 | $117.49 | $120.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $58.88 Typical High $60.26 | Professional | 52 · Reduced service | $53.70 | $58.88 | $60.26 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.44 Typical High $23.99 | Professional | 53 · Discontinued | $21.38 | $23.44 | $23.99 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $18.20 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $18.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.75 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.72 | $11.75 | $12.02 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $316.23 Typical High $331.13 | Professional | None | $134.90 | $316.23 | $331.13 |
UPMC Health Plan Setting Facility Modifier None Typical Low $117.49 Median $537.03 Typical High $912.01 | Facility | None | $117.49 | $537.03 | $912.01 |
UPMC Health Plan Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $234.42 | Professional | None | $117.49 | $117.49 | $234.42 |
United Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $338.84 | Facility | None | $85.11 | $109.65 | $338.84 |
United Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $204.17 | Professional | None | $104.71 | $123.03 | $204.17 |
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 $223.87 Median $245.47 Typical High $245.47 | Professional | 50 · Both sides | $223.87 | $245.47 | $245.47 |
Where Pennsylvania sits
The same service costs 2.0 times more in Wisconsin 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
$129
WI $257DE $129
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.