How much rates vary
Facilitymedian $1,479 · 10th to 90th $933 to $5,248Professionalmedian $1,072 · 10th to 90th $871 to $1,950
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 $870.96 Median $870.96 Typical High $912.01 | Facility | None | $870.96 | $870.96 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $954.99 | Professional | None | $851.14 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $87.10 | $95.50 |
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 $1,584.89 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,584.89 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $9,772.37 | Professional | None | $1,071.52 | $1,071.52 | $9,772.37 |
Emblem Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,235.94 Typical High $3,715.35 | Professional | None | $2,041.74 | $3,235.94 | $3,715.35 |
Geisinger Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Geisinger Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,202.26 | $1,995.26 |
Martin's Point Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Martin's Point Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $954.99 | Professional | None | $851.14 | $912.01 | $954.99 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $457.09 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $457.09 | $478.63 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $181.97 | $190.55 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $144.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $95.50 |
Oscar Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $3,311.31 | Professional | None | $1,348.96 | $2,290.87 | $3,311.31 |
UPMC Health Plan Setting Facility Modifier None Typical Low $933.25 Median $4,265.80 Typical High $7,244.36 | Facility | None | $933.25 | $4,265.80 | $7,244.36 |
UPMC Health Plan Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,862.09 | Professional | None | $933.25 | $933.25 | $1,862.09 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $2,818.38 | Facility | None | $954.99 | $1,148.15 | $2,818.38 |
United Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,621.81 | Professional | None | $851.14 | $977.24 | $1,621.81 |
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 $1,737.80 Median $1,949.84 Typical High $1,949.84 | Professional | 50 · Both sides | $1,737.80 | $1,949.84 | $1,949.84 |
Where Pennsylvania sits
The same service costs 2.5 times more in Hawaii than in Rhode Island. 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· 37th of 51
$1,072
HI $2,570RI $1,023
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.