How much rates vary
Facilitymedian $170 · 10th to 90th $107 to $1,047Professionalmedian $141 · 10th to 90th $91 to $204
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 $91.20 Median $91.20 Typical High $95.50 | Facility | None | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $100.00 | Professional | None | $91.20 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $47.86 Typical High $50.12 | Professional | 52 · Reduced service | $45.71 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $19.95 | Professional | 53 · Discontinued | $18.20 | $19.50 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $15.14 | Professional | 55 · Aftercare only | $13.80 | $14.45 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.55 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.12 | $9.55 | $10.00 |
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 $162.18 Median $204.17 Typical High $204.17 | Professional | None | $162.18 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $1,202.26 | Professional | None | $123.03 | $123.03 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $467.74 | Professional | None | $257.04 | $398.11 | $467.74 |
Geisinger Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Geisinger Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $208.93 | Professional | None | $107.15 | $125.89 | $208.93 |
Highmark BCBS Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $165.96 | Professional | None | $144.54 | $144.54 | $165.96 |
Martin's Point Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Martin's Point Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $100.00 | Professional | None | $91.20 | $95.50 | $100.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $47.86 Typical High $50.12 | Professional | 52 · Reduced service | $45.71 | $47.86 | $50.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $19.95 | Professional | 53 · Discontinued | $18.20 | $19.50 | $19.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $15.14 | Professional | 55 · Aftercare only | $13.80 | $14.45 | $15.14 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.55 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.12 | $9.55 | $10.00 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $389.05 Typical High $407.38 | Professional | None | $169.82 | $389.05 | $407.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $141.25 Median $645.65 Typical High $1,096.48 | Facility | None | $141.25 | $645.65 | $1,096.48 |
UPMC Health Plan Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
United Setting Facility Modifier None Typical Low $107.15 Median $134.90 Typical High $331.13 | Facility | None | $107.15 | $134.90 | $331.13 |
United Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $169.82 | Professional | None | $91.20 | $102.33 | $169.82 |
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 $186.21 Median $204.17 Typical High $204.17 | Professional | 50 · Both sides | $186.21 | $204.17 | $204.17 |
Where Pennsylvania sits
The same service costs 2.7 times more in Hawaii than in Washington, DC. 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· 29th of 51
$141
HI $295DC $110
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.