How much rates vary
Facilitymedian $112 · 10th to 90th $78 to $631Professionalmedian $87 · 10th to 90th $78 to $174
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 $77.62 Median $77.62 Typical High $83.18 | Facility | None | $77.62 | $77.62 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $87.10 | Professional | None | $77.62 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | 52 · Reduced service | $38.90 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.60 Typical High $17.38 | Professional | 53 · Discontinued | $15.85 | $16.60 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $12.88 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $8.71 |
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 $144.54 Median $173.78 Typical High $173.78 | Professional | None | $144.54 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $954.99 | Professional | None | $83.18 | $83.18 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $363.08 | Professional | None | $199.53 | $309.03 | $363.08 |
Geisinger Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Geisinger Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $177.83 | Professional | None | $93.33 | $107.15 | $177.83 |
Highmark BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Martin's Point Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Martin's Point Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $87.10 | Professional | None | $77.62 | $83.18 | $87.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $41.69 Typical High $42.66 | Professional | 52 · Reduced service | $38.90 | $41.69 | $42.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.60 Typical High $17.38 | Professional | 53 · Discontinued | $15.85 | $16.60 | $17.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.59 Typical High $12.88 | Professional | 55 · Aftercare only | $11.75 | $12.59 | $12.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $8.71 |
Oscar Health Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $316.23 | Professional | None | $128.82 | $218.78 | $316.23 |
UPMC Health Plan Setting Facility Modifier None Typical Low $83.18 Median $380.19 Typical High $660.69 | Facility | None | $83.18 | $380.19 | $660.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $165.96 | Professional | None | $83.18 | $83.18 | $165.96 |
United Setting Facility Modifier None Typical Low $75.86 Median $104.71 Typical High $288.40 | Facility | None | $75.86 | $104.71 | $288.40 |
United Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $144.54 | Professional | None | $79.43 | $89.13 | $144.54 |
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 $158.49 Median $173.78 Typical High $173.78 | Professional | 50 · Both sides | $158.49 | $173.78 | $173.78 |
Where Pennsylvania sits
The same service costs 2.8 times more in Hawaii 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· 49th of 51
$87.10
HI $234DE $83.18
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.