How much rates vary
Facilitymedian $275 · 10th to 90th $234 to $1,862Professionalmedian $251 · 10th to 90th $200 to $501
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 $234.42 Median $234.42 Typical High $245.47 | Facility | None | $234.42 | $234.42 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $257.04 | Professional | None | $229.09 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $114.82 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $23.44 | $25.70 |
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 $398.11 Median $398.11 Typical High $426.58 | Professional | None | $398.11 | $398.11 | $426.58 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $524.81 Typical High $524.81 | Professional | 50 · Both sides | $467.74 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $281.84 | Facility | None | $275.42 | $275.42 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $2,344.23 | Professional | None | $199.53 | $199.53 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $758.58 | Professional | None | $416.87 | $660.69 | $758.58 |
Geisinger Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Geisinger Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $537.03 | Professional | None | $275.42 | $323.59 | $537.03 |
Martin's Point Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Martin's Point Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $257.04 | Professional | None | $229.09 | $245.47 | $257.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $114.82 | $120.23 | $128.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $47.86 | $51.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $36.31 Typical High $38.90 | Professional | 55 · Aftercare only | $34.67 | $36.31 | $38.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $23.99 | $25.70 |
Oscar Health Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $676.08 | Professional | None | $275.42 | $457.09 | $676.08 |
UPMC Health Plan Setting Facility Modifier None Typical Low $251.19 Median $1,148.15 Typical High $1,949.84 | Facility | None | $251.19 | $1,148.15 | $1,949.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $501.19 | Professional | None | $251.19 | $251.19 | $501.19 |
United Setting Facility Modifier None Typical Low $218.78 Median $275.42 Typical High $676.08 | Facility | None | $218.78 | $275.42 | $676.08 |
United Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $407.38 | Professional | None | $208.93 | $263.03 | $407.38 |
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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | KX · Policy requirements met | $389.05 | $389.05 | $389.05 |
Where Pennsylvania sits
The same service costs 2.9 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· 40th of 51
$251
HI $617FL $214
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.