How much rates vary
Facilitymedian $126 · 10th to 90th $51 to $4,266Professionalmedian $51 · 10th to 90th $26 to $72
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 $56.23 Median $63.10 Typical High $63.10 | Facility | None | $56.23 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $63.10 | Professional | None | $45.71 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $28.18 Typical High $31.62 | Professional | 52 · Reduced service | $22.91 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $11.22 Typical High $12.59 | Professional | 53 · Discontinued | $9.12 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $9.33 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.62 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.57 | $5.62 | $6.31 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Emblem Health Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $128.82 | Professional | None | $77.62 | $102.33 | $128.82 |
Geisinger Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Geisinger Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $72.44 | Professional | None | $43.65 | $56.23 | $72.44 |
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 |
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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Martin's Point Setting Professional Modifier None Typical Low $47.86 Median $56.23 Typical High $63.10 | Professional | None | $47.86 | $56.23 | $63.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $28.18 Typical High $31.62 | Professional | 52 · Reduced service | $23.99 | $28.18 | $31.62 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.22 Typical High $12.59 | Professional | 53 · Discontinued | $9.55 | $11.22 | $12.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.32 Typical High $9.33 | Professional | 55 · Aftercare only | $7.08 | $8.32 | $9.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.62 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.79 | $5.62 | $6.31 |
Oscar Health Setting Professional Modifier None Typical Low $25.12 Median $97.72 Typical High $97.72 | Professional | None | $25.12 | $97.72 | $97.72 |
UPMC Health Plan Setting Facility Modifier None Typical Low $51.29 Median $234.42 Typical High $398.11 | Facility | None | $51.29 | $234.42 | $398.11 |
UPMC Health Plan Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $67.61 | Professional | None | $50.12 | $51.29 | $67.61 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $87.10 | Facility | None | $72.44 | $72.44 | $87.10 |
United Setting Professional Modifier None Typical Low $10.00 Median $35.48 Typical High $38.90 | Professional | None | $10.00 | $35.48 | $38.90 |
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 3.3 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· 10th of 51
$51.29
MT $87.10IN $26.30
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.