How much rates vary
Facilitymedian $98 · 10th to 90th $39 to $4,266Professionalmedian $39 · 10th to 90th $20 to $48
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 $42.66 Median $47.86 Typical High $47.86 | Facility | None | $42.66 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $47.86 | Professional | None | $33.11 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $21.38 Typical High $23.99 | Professional | 52 · Reduced service | $16.98 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.51 Typical High $9.55 | Professional | 53 · Discontinued | $6.76 | $8.51 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.31 Typical High $7.08 | Professional | 55 · Aftercare only | $5.13 | $6.31 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.27 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.39 | $4.27 | $4.79 |
Ambetter Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
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 $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Emblem Health Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $102.33 | Professional | None | $61.66 | $81.28 | $102.33 |
Geisinger Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Geisinger Setting Professional Modifier None Typical Low $33.11 Median $42.66 Typical High $54.95 | Professional | None | $33.11 | $42.66 | $54.95 |
Highmark BCBS Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $26.92 | Facility | None | $6.92 | $6.92 | $26.92 |
Highmark BCBS Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Martin's Point Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $47.86 | Professional | None | $33.88 | $42.66 | $47.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $21.38 Typical High $23.99 | Professional | 52 · Reduced service | $17.78 | $21.38 | $23.99 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.51 Typical High $9.55 | Professional | 53 · Discontinued | $7.08 | $8.51 | $9.55 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $6.31 Typical High $7.08 | Professional | 55 · Aftercare only | $5.37 | $6.31 | $7.08 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.27 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.55 | $4.27 | $4.79 |
Oscar Health Setting Professional Modifier None Typical Low $25.12 Median $77.62 Typical High $77.62 | Professional | None | $25.12 | $77.62 | $77.62 |
UPMC Health Plan Setting Facility Modifier None Typical Low $38.90 Median $177.83 Typical High $302.00 | Facility | None | $38.90 | $177.83 | $302.00 |
UPMC Health Plan Setting Professional Modifier None Typical Low $38.02 Median $38.90 Typical High $51.29 | Professional | None | $38.02 | $38.90 | $51.29 |
United Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $66.07 | Facility | None | $54.95 | $54.95 | $66.07 |
United Setting Professional Modifier None Typical Low $10.00 Median $26.92 Typical High $29.51 | Professional | None | $10.00 | $26.92 | $29.51 |
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 3.2 times more in Montana than in Indiana. 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· 11th of 51
$38.90
MT $64.57IN $19.95
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.