How much rates vary
Facilitymedian $35 · 10th to 90th $28 to $224Professionalmedian $32 · 10th to 90th $25 to $63
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 $28.18 Median $28.18 Typical High $29.51 | Facility | None | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $28.18 Typical High $30.90 | Professional | None | $27.54 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $14.13 Typical High $15.49 | Professional | 52 · Reduced service | $13.80 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.62 Typical High $6.17 | Professional | 53 · Discontinued | $5.50 | $5.62 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.27 Typical High $4.68 | Professional | 55 · Aftercare only | $4.17 | $4.27 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.82 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.75 | $2.82 | $3.09 |
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 $51.29 Median $63.10 Typical High $63.10 | Professional | None | $51.29 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $295.12 | Professional | None | $25.12 | $25.12 | $295.12 |
Emblem Health Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $109.65 | Professional | None | $60.26 | $95.50 | $109.65 |
Geisinger Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Geisinger Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $64.57 | Professional | None | $33.11 | $38.90 | $64.57 |
Highmark BCBS Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Martin's Point Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Martin's Point Setting Professional Modifier None Typical Low $27.54 Median $28.84 Typical High $30.90 | Professional | None | $27.54 | $28.84 | $30.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $14.45 Typical High $15.49 | Professional | 52 · Reduced service | $13.80 | $14.45 | $15.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.75 Typical High $6.17 | Professional | 53 · Discontinued | $5.50 | $5.75 | $6.17 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.27 Typical High $4.68 | Professional | 55 · Aftercare only | $4.17 | $4.27 | $4.68 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.88 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.75 | $2.88 | $3.09 |
Oscar Health Setting Professional Modifier None Typical Low $39.81 Median $91.20 Typical High $97.72 | Professional | None | $39.81 | $91.20 | $97.72 |
UPMC Health Plan Setting Facility Modifier None Typical Low $30.20 Median $138.04 Typical High $234.42 | Facility | None | $30.20 | $138.04 | $234.42 |
UPMC Health Plan Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | None | $30.20 | $30.20 | $60.26 |
United Setting Facility Modifier None Typical Low $27.54 Median $29.51 Typical High $91.20 | Facility | None | $27.54 | $29.51 | $91.20 |
United Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $52.48 | Professional | None | $27.54 | $31.62 | $52.48 |
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 $56.23 Median $63.10 Typical High $63.10 | Professional | 50 · Both sides | $56.23 | $63.10 | $63.10 |
Where Pennsylvania sits
The same service costs 2.5 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· 45th of 51
$31.62
HI $64.57DE $25.70
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.