How much rates vary
Facilitymedian $14 · 10th to 90th $13 to $107Professionalmedian $14 · 10th to 90th $9 to $21
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 $9.33 Median $9.33 Typical High $9.77 | Facility | None | $9.33 | $9.33 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $9.77 Typical High $10.23 | Professional | None | $9.33 | $9.77 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.68 Median $4.90 Typical High $5.13 | Professional | 52 · Reduced service | $4.68 | $4.90 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $1.95 Typical High $2.04 | Professional | 53 · Discontinued | $1.86 | $1.95 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.48 Typical High $1.51 | Professional | 55 · Aftercare only | $1.41 | $1.48 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $1.00 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.93 | $1.00 | $1.02 |
Ambetter Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $18.20 | Professional | None | $15.85 | $15.85 | $18.20 |
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 $16.60 Median $20.89 Typical High $20.89 | Professional | None | $16.60 | $20.89 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $107.15 | Professional | None | $10.47 | $10.47 | $107.15 |
Emblem Health Setting Professional Modifier None Typical Low $23.44 Median $37.15 Typical High $43.65 | Professional | None | $23.44 | $37.15 | $43.65 |
Geisinger Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Geisinger Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $21.38 | Professional | None | $10.96 | $12.88 | $21.38 |
Highmark BCBS Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $15.49 | Professional | None | $14.45 | $14.45 | $15.49 |
Martin's Point Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier None Typical Low $9.33 Median $9.77 Typical High $10.23 | Professional | None | $9.33 | $9.77 | $10.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $4.68 Median $4.90 Typical High $5.13 | Professional | 52 · Reduced service | $4.68 | $4.90 | $5.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $1.95 Typical High $2.04 | Professional | 53 · Discontinued | $1.86 | $1.95 | $2.04 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.48 Typical High $1.51 | Professional | 55 · Aftercare only | $1.41 | $1.48 | $1.51 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $1.00 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.93 | $1.00 | $1.02 |
Oscar Health Setting Professional Modifier None Typical Low $10.00 Median $22.91 Typical High $36.31 | Professional | None | $10.00 | $22.91 | $36.31 |
UPMC Health Plan Setting Facility Modifier None Typical Low $14.45 Median $66.07 Typical High $112.20 | Facility | None | $14.45 | $66.07 | $112.20 |
UPMC Health Plan Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $19.95 | Professional | None | $14.45 | $14.45 | $19.95 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.88 Typical High $30.90 | Facility | None | $12.59 | $12.88 | $30.90 |
United Setting Professional Modifier None Typical Low $9.33 Median $10.47 Typical High $17.38 | Professional | None | $9.33 | $10.47 | $17.38 |
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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $18.62 Median $20.89 Typical High $20.89 | Professional | 50 · Both sides | $18.62 | $20.89 | $20.89 |
Where Pennsylvania sits
The same service costs 3.0 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· 22nd of 51
$14.45
HI $31.62DE $10.47
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.