How much rates vary
Facilitymedian $174 · 10th to 90th $69 to $5,012Professionalmedian $68 · 10th to 90th $44 to $95
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 $75.86 Median $85.11 Typical High $85.11 | Facility | None | $75.86 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $85.11 | Professional | None | $67.61 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $37.15 Typical High $41.69 | Professional | 52 · Reduced service | $33.88 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $15.14 Typical High $16.98 | Professional | 53 · Discontinued | $13.80 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.22 Typical High $12.59 | Professional | 55 · Aftercare only | $10.23 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.59 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.76 | $7.59 | $8.51 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $173.78 | Professional | None | $102.33 | $134.90 | $173.78 |
Geisinger Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Geisinger Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $97.72 | Professional | None | $58.88 | $75.86 | $97.72 |
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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $85.11 | Professional | None | $67.61 | $75.86 | $85.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $37.15 Typical High $41.69 | Professional | 52 · Reduced service | $33.88 | $37.15 | $41.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $15.14 Typical High $16.98 | Professional | 53 · Discontinued | $13.80 | $15.14 | $16.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.22 Typical High $12.59 | Professional | 55 · Aftercare only | $10.23 | $11.22 | $12.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.59 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.76 | $7.59 | $8.51 |
Oscar Health Setting Professional Modifier None Typical Low $25.12 Median $131.83 Typical High $131.83 | Professional | None | $25.12 | $131.83 | $131.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $69.18 Median $316.23 Typical High $537.03 | Facility | None | $69.18 | $316.23 | $537.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $91.20 | Professional | None | $66.07 | $69.18 | $91.20 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $144.54 | Facility | None | $120.23 | $120.23 | $144.54 |
United Setting Professional Modifier None Typical Low $10.00 Median $47.86 Typical High $52.48 | Professional | None | $10.00 | $47.86 | $52.48 |
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 3.5 times more in Hawaii 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· 23rd of 51
$67.61
HI $132NY $38.02
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.