How much rates vary
Facilitymedian $56 · 10th to 90th $45 to $468Professionalmedian $50 · 10th to 90th $37 to $89
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 $39.81 Median $39.81 Typical High $41.69 | Facility | None | $39.81 | $39.81 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $43.65 | Professional | None | $38.90 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $20.42 Typical High $21.88 | Professional | 52 · Reduced service | $19.50 | $20.42 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.13 Typical High $8.71 | Professional | 53 · Discontinued | $7.76 | $8.13 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.17 Typical High $6.46 | Professional | 55 · Aftercare only | $5.75 | $6.17 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.07 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.89 | $4.07 | $4.37 |
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 $72.44 Median $89.13 Typical High $89.13 | Professional | None | $72.44 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $446.68 | Professional | None | $37.15 | $37.15 | $446.68 |
Emblem Health Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $151.36 | Professional | None | $83.18 | $131.83 | $151.36 |
Geisinger Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Geisinger Setting Professional Modifier None Typical Low $46.77 Median $53.70 Typical High $91.20 | Professional | None | $46.77 | $53.70 | $91.20 |
Highmark BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | None | $61.66 | $61.66 | $66.07 |
Martin's Point Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Martin's Point Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $43.65 | Professional | None | $38.90 | $40.74 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $20.89 Typical High $21.88 | Professional | 52 · Reduced service | $19.50 | $20.89 | $21.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.32 Typical High $8.71 | Professional | 53 · Discontinued | $7.76 | $8.32 | $8.71 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.31 Typical High $6.46 | Professional | 55 · Aftercare only | $5.89 | $6.31 | $6.46 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.17 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.89 | $4.17 | $4.37 |
Oscar Health Setting Professional Modifier None Typical Low $54.95 Median $125.89 Typical High $134.90 | Professional | None | $54.95 | $125.89 | $134.90 |
UPMC Health Plan Setting Facility Modifier None Typical Low $63.10 Median $288.40 Typical High $489.78 | Facility | None | $63.10 | $288.40 | $489.78 |
UPMC Health Plan Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | None | $63.10 | $63.10 | $85.11 |
United Setting Facility Modifier None Typical Low $44.67 Median $109.65 Typical High $131.83 | Facility | None | $44.67 | $109.65 | $131.83 |
United Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $74.13 | Professional | None | $39.81 | $44.67 | $74.13 |
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 $79.43 Median $89.13 Typical High $89.13 | Professional | 50 · Both sides | $79.43 | $89.13 | $89.13 |
Where Pennsylvania sits
The same service costs 2.8 times more in Kansas 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· 39th of 51
$50.12
KS $107DE $38.90
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.