How much rates vary
Facilitymedian $17 · 10th to 90th $13 to $100Professionalmedian $14 · 10th to 90th $12 to $28
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 $12.30 Median $12.30 Typical High $13.18 | Facility | None | $12.30 | $12.30 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $13.80 | Professional | None | $12.30 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.17 Median $6.17 Typical High $6.76 | Professional | 52 · Reduced service | $6.17 | $6.17 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.51 Typical High $2.75 | Professional | 53 · Discontinued | $2.45 | $2.51 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.86 Typical High $2.04 | Professional | 55 · Aftercare only | $1.82 | $1.86 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.38 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
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 $22.39 Median $27.54 Typical High $27.54 | Professional | None | $22.39 | $27.54 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $138.04 | Professional | None | $12.02 | $12.02 | $138.04 |
Emblem Health Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $52.48 | Professional | None | $28.84 | $44.67 | $52.48 |
Geisinger Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Geisinger Setting Professional Modifier None Typical Low $15.14 Median $16.98 Typical High $28.18 | Professional | None | $15.14 | $16.98 | $28.18 |
Highmark BCBS Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Martin's Point Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Martin's Point Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $13.80 | Professional | None | $12.30 | $12.30 | $13.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.17 Median $6.61 Typical High $6.76 | Professional | 52 · Reduced service | $6.17 | $6.61 | $6.76 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.63 Typical High $2.75 | Professional | 53 · Discontinued | $2.45 | $2.63 | $2.75 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.00 Typical High $2.04 | Professional | 55 · Aftercare only | $1.82 | $2.00 | $2.04 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.32 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.23 | $1.32 | $1.38 |
Oscar Health Setting Professional Modifier None Typical Low $18.62 Median $31.62 Typical High $45.71 | Professional | None | $18.62 | $31.62 | $45.71 |
UPMC Health Plan Setting Facility Modifier None Typical Low $13.18 Median $60.26 Typical High $104.71 | Facility | None | $13.18 | $60.26 | $104.71 |
UPMC Health Plan Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $26.30 | Professional | None | $13.18 | $13.18 | $26.30 |
United Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $40.74 | Facility | None | $12.88 | $16.22 | $40.74 |
United Setting Professional Modifier None Typical Low $12.30 Median $13.80 Typical High $22.91 | Professional | None | $12.30 | $13.80 | $22.91 |
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 $25.12 Median $27.54 Typical High $27.54 | Professional | 50 · Both sides | $25.12 | $27.54 | $27.54 |
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· 48th of 51
$13.80
HI $36.31DE $12.02
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.