How much rates vary
Facilitymedian $7 · 10th to 90th $5 to $39Professionalmedian $5 · 10th to 90th $5 to $11
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 $4.90 Median $4.90 Typical High $5.25 | Facility | None | $4.90 | $4.90 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.90 Typical High $5.37 | Professional | None | $4.79 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.40 Median $2.57 Typical High $2.69 | Professional | 52 · Reduced service | $2.40 | $2.57 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $1.02 Typical High $1.07 | Professional | 53 · Discontinued | $0.98 | $1.02 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.78 Typical High $0.81 | Professional | 55 · Aftercare only | $0.72 | $0.78 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.52 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.48 | $0.52 | $0.54 |
Ambetter Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
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 $8.91 Median $10.96 Typical High $10.96 | Professional | None | $8.91 | $10.96 | $10.96 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $60.26 | Professional | None | $5.25 | $5.25 | $60.26 |
Emblem Health Setting Professional Modifier None Typical Low $10.47 Median $16.22 Typical High $19.05 | Professional | None | $10.47 | $16.22 | $19.05 |
Geisinger Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Geisinger Setting Professional Modifier None Typical Low $6.03 Median $6.76 Typical High $11.22 | Professional | None | $6.03 | $6.76 | $11.22 |
Highmark BCBS Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Martin's Point Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
Martin's Point Setting Professional Modifier None Typical Low $4.79 Median $5.25 Typical High $5.37 | Professional | None | $4.79 | $5.25 | $5.37 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $2.63 Typical High $2.69 | Professional | 52 · Reduced service | $2.45 | $2.63 | $2.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.05 Typical High $1.07 | Professional | 53 · Discontinued | $1.00 | $1.05 | $1.07 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.74 Median $0.78 Typical High $0.81 | Professional | 55 · Aftercare only | $0.74 | $0.78 | $0.81 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.52 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.49 | $0.52 | $0.54 |
Oscar Health Setting Professional Modifier None Typical Low $6.76 Median $15.85 Typical High $16.60 | Professional | None | $6.76 | $15.85 | $16.60 |
UPMC Health Plan Setting Facility Modifier None Typical Low $5.25 Median $23.99 Typical High $40.74 | Facility | None | $5.25 | $23.99 | $40.74 |
UPMC Health Plan Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $10.47 | Professional | None | $5.25 | $5.25 | $10.47 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $18.20 | Facility | None | $6.31 | $7.94 | $18.20 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.50 Typical High $9.12 | Professional | None | $5.01 | $5.50 | $9.12 |
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 $10.00 Median $10.96 Typical High $10.96 | Professional | 50 · Both sides | $10.00 | $10.96 | $10.96 |
Where Pennsylvania sits
The same service costs 3.5 times more in Montana than in Kansas. 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
$5.50
MT $15.49KS $4.37
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.