How much rates vary
Facilitymedian $158 · 10th to 90th $63 to $5,012Professionalmedian $63 · 10th to 90th $34 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 $69.18 Median $77.62 Typical High $77.62 | Facility | None | $69.18 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $77.62 | Professional | None | $57.54 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $34.67 Typical High $38.90 | Professional | 52 · Reduced service | $29.51 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $13.80 Typical High $15.49 | Professional | 53 · Discontinued | $11.75 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.47 Typical High $11.75 | Professional | 55 · Aftercare only | $8.71 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.92 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.89 | $6.92 | $7.76 |
AmeriHealth Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
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 $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $144.54 | Professional | None | $85.11 | $112.20 | $144.54 |
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 $54.95 Median $70.79 Typical High $91.20 | Professional | None | $54.95 | $70.79 | $91.20 |
Independence Blue Cross Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Martin's Point Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Martin's Point Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $77.62 | Professional | None | $63.10 | $69.18 | $77.62 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $34.67 Typical High $38.90 | Professional | 52 · Reduced service | $31.62 | $34.67 | $38.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.80 Typical High $15.49 | Professional | 53 · Discontinued | $12.59 | $13.80 | $15.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.47 Typical High $11.75 | Professional | 55 · Aftercare only | $9.55 | $10.47 | $11.75 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.92 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.31 | $6.92 | $7.76 |
Oscar Health Setting Professional Modifier None Typical Low $25.12 Median $109.65 Typical High $109.65 | Professional | None | $25.12 | $109.65 | $109.65 |
UPMC Health Plan Setting Facility Modifier None Typical Low $63.10 Median $288.40 Typical High $501.19 | Facility | None | $63.10 | $288.40 | $501.19 |
UPMC Health Plan Setting Professional Modifier None Typical Low $61.66 Median $63.10 Typical High $85.11 | Professional | None | $61.66 | $63.10 | $85.11 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $114.82 | Facility | None | $95.50 | $95.50 | $114.82 |
United Setting Professional Modifier None Typical Low $10.00 Median $44.67 Typical High $47.86 | Professional | None | $10.00 | $44.67 | $47.86 |
3 more rates 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 |
|---|---|---|---|---|---|
AmeriHealth Setting Professional Modifier GX · Voluntary liability notice Typical Low $12.59 Median $12.88 Typical High $12.88 | Professional | GX · Voluntary liability notice | $12.59 | $12.88 | $12.88 |
Independence Blue Cross Setting Professional Modifier GX · Voluntary liability notice Typical Low $12.59 Median $12.88 Typical High $12.88 | Professional | GX · Voluntary liability notice | $12.59 | $12.88 | $12.88 |
Oscar Health Setting Professional Modifier GX · Voluntary liability notice Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | GX · Voluntary liability notice | $12.59 | $12.59 | $12.59 |
Where Pennsylvania sits
The same service costs 3.1 times more in Montana than in New York. 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· 12th of 51
$63.10
MT $100NY $32.36
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.