How much rates vary
Facilitymedian $27 · 10th to 90th $22 to $174Professionalmedian $21 · 10th to 90th $14 to $31
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 $13.80 Median $13.80 Typical High $14.45 | Facility | None | $13.80 | $13.80 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $14.13 Typical High $15.14 | Professional | None | $13.49 | $14.13 | $15.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $7.08 Typical High $7.59 | Professional | 52 · Reduced service | $6.76 | $7.08 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.82 Typical High $3.02 | Professional | 53 · Discontinued | $2.69 | $2.82 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.14 Typical High $2.29 | Professional | 55 · Aftercare only | $2.04 | $2.14 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.41 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.35 | $1.41 | $1.51 |
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 $24.55 Median $30.90 Typical High $30.90 | Professional | None | $24.55 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $141.25 | Professional | None | $21.38 | $21.38 | $141.25 |
Emblem Health Setting Professional Modifier None Typical Low $28.84 Median $45.71 Typical High $52.48 | Professional | None | $28.84 | $45.71 | $52.48 |
Geisinger Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Geisinger Setting Professional Modifier None Typical Low $19.05 Median $21.88 Typical High $31.62 | Professional | None | $19.05 | $21.88 | $31.62 |
Martin's Point Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Martin's Point Setting Professional Modifier None Typical Low $13.49 Median $14.45 Typical High $15.14 | Professional | None | $13.49 | $14.45 | $15.14 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $7.24 Typical High $7.59 | Professional | 52 · Reduced service | $6.76 | $7.24 | $7.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.95 Typical High $3.02 | Professional | 53 · Discontinued | $2.75 | $2.95 | $3.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.19 Typical High $2.29 | Professional | 55 · Aftercare only | $2.04 | $2.19 | $2.29 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.45 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.35 | $1.45 | $1.51 |
Oscar Health Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $46.77 | Professional | None | $31.62 | $43.65 | $46.77 |
UPMC Health Plan Setting Facility Modifier None Typical Low $21.88 Median $100.00 Typical High $173.78 | Facility | None | $21.88 | $100.00 | $173.78 |
UPMC Health Plan Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $29.51 | Professional | None | $21.88 | $21.88 | $29.51 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $45.71 | Facility | None | $38.90 | $38.90 | $45.71 |
United Setting Professional Modifier None Typical Low $13.80 Median $15.49 Typical High $23.99 | Professional | None | $13.80 | $15.49 | $23.99 |
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 $27.54 Median $30.90 Typical High $30.90 | Professional | 50 · Both sides | $27.54 | $30.90 | $30.90 |
Where Pennsylvania sits
The same service costs 2.1 times more in Minnesota 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· 41st of 51
$21.38
MN $37.15DC $17.38
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.