How much rates vary
Facilitymedian $295 · 10th to 90th $186 to $1,995Professionalmedian $269 · 10th to 90th $174 to $389
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 $173.78 Median $173.78 Typical High $181.97 | Facility | None | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $190.55 | Professional | None | $169.82 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $91.20 Typical High $95.50 | Professional | 52 · Reduced service | $85.11 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $36.31 Typical High $38.02 | Professional | 53 · Discontinued | $33.88 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $28.84 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $19.05 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
AmeriHealth Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $309.03 Median $389.05 Typical High $389.05 | Professional | None | $309.03 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $302.00 | Facility | None | $295.12 | $295.12 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $2,089.30 | Professional | None | $213.80 | $213.80 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $660.69 | Professional | None | $363.08 | $575.44 | $660.69 |
Geisinger Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Geisinger Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $398.11 | Professional | None | $204.17 | $239.88 | $398.11 |
Highmark BCBS Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $331.13 | Professional | None | $269.15 | $288.40 | $331.13 |
Independence Blue Cross Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Martin's Point Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $190.55 | Professional | None | $169.82 | $181.97 | $190.55 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $91.20 Typical High $95.50 | Professional | 52 · Reduced service | $87.10 | $91.20 | $95.50 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $37.15 Typical High $38.02 | Professional | 53 · Discontinued | $34.67 | $37.15 | $38.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $27.54 Typical High $28.84 | Professional | 55 · Aftercare only | $26.30 | $27.54 | $28.84 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.20 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $18.20 | $19.05 |
Oscar Health Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $588.84 | Professional | None | $239.88 | $407.38 | $588.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $269.15 Median $1,258.93 Typical High $2,187.76 | Facility | None | $269.15 | $1,258.93 | $2,187.76 |
UPMC Health Plan Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $371.54 | Professional | None | $269.15 | $269.15 | $371.54 |
United Setting Facility Modifier None Typical Low $186.21 Median $251.19 Typical High $512.86 | Facility | None | $186.21 | $251.19 | $512.86 |
United Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $338.84 | Professional | None | $173.78 | $194.98 | $338.84 |
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 $346.74 Median $389.05 Typical High $389.05 | Professional | 50 · Both sides | $346.74 | $389.05 | $389.05 |
Where Pennsylvania sits
The same service costs 2.5 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· 33rd of 51
$269
HI $513DC $209
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.