How much rates vary
Facilitymedian $166 · 10th to 90th $115 to $851Professionalmedian $120 · 10th to 90th $107 to $240
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 $107.15 Median $107.15 Typical High $112.20 | Facility | None | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $117.49 | Professional | None | $104.71 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $53.70 Typical High $58.88 | Professional | 52 · Reduced service | $52.48 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $23.44 | Professional | 53 · Discontinued | $20.89 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.22 Typical High $17.78 | Professional | 55 · Aftercare only | $15.85 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $11.75 |
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 $190.55 Median $239.88 Typical High $239.88 | Professional | None | $190.55 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $1,174.90 | Professional | None | $120.23 | $120.23 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $416.87 | Professional | None | $229.09 | $354.81 | $416.87 |
Geisinger Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Geisinger Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $245.47 | Professional | None | $125.89 | $147.91 | $245.47 |
Highmark BCBS Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Martin's Point Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Martin's Point Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $117.49 | Professional | None | $104.71 | $112.20 | $117.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $56.23 Typical High $58.88 | Professional | 52 · Reduced service | $52.48 | $56.23 | $58.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $23.44 | Professional | 53 · Discontinued | $20.89 | $22.91 | $23.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $17.78 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $17.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.22 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.47 | $11.22 | $11.75 |
Oscar Health Setting Professional Modifier None Typical Low $151.36 Median $346.74 Typical High $363.08 | Professional | None | $151.36 | $346.74 | $363.08 |
UPMC Health Plan Setting Facility Modifier None Typical Low $114.82 Median $524.81 Typical High $891.25 | Facility | None | $114.82 | $524.81 | $891.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $229.09 | Professional | None | $114.82 | $114.82 | $229.09 |
United Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $346.74 | Facility | None | $138.04 | $141.25 | $346.74 |
United Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $199.53 | Professional | None | $104.71 | $120.23 | $199.53 |
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 $213.80 Median $239.88 Typical High $239.88 | Professional | 50 · Both sides | $213.80 | $239.88 | $239.88 |
Where Pennsylvania sits
The same service costs 2.8 times more in Hawaii than in Florida. 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· 46th of 51
$120
HI $331FL $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.