How much rates vary
Facilitymedian $240 · 10th to 90th $151 to $490Professionalmedian $151 · 10th to 90th $126 to $331
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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $154.88 | Professional | None | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Capital Blue Cross Setting Facility Modifier None Typical Low $295.12 Median $331.13 Typical High $5,011.87 | Facility | None | $295.12 | $331.13 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | None | $302.00 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $213.80 Typical High $489.78 | Facility | None | $125.89 | $213.80 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $162.18 | Professional | None | $125.89 | $125.89 | $162.18 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $338.84 | Professional | None | $190.55 | $288.40 | $338.84 |
Geisinger Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $229.09 | Professional | None | $123.03 | $158.49 | $229.09 |
Martin's Point Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Oscar Health Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $245.47 | Professional | None | $165.96 | $181.97 | $245.47 |
UPMC Health Plan Setting Facility Modifier None Typical Low $154.88 Median $194.98 Typical High $309.03 | Facility | None | $154.88 | $194.98 | $309.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $177.83 | Professional | None | $154.88 | $177.83 | $177.83 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $165.96 | Professional | None | $114.82 | $125.89 | $165.96 |
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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier PN · Off-campus dept, non-excepted Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | PN · Off-campus dept, non-excepted | $562.34 | $562.34 | $562.34 |
Where Pennsylvania sits
The same service costs 2.9 times more in Wyoming than in North Carolina. 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· 23rd of 51
$151
WY $339NC $117
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.