How much rates vary
Facilitymedian $209 · 10th to 90th $83 to $5,012Professionalmedian $83 · 10th to 90th $43 to $117
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 $91.20 Median $102.33 Typical High $102.33 | Facility | None | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $102.33 | Professional | None | $72.44 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $45.71 Typical High $51.29 | Professional | 52 · Reduced service | $36.31 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.20 Typical High $20.42 | Professional | 53 · Discontinued | $14.79 | $18.20 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.80 Typical High $15.49 | Professional | 55 · Aftercare only | $10.96 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.12 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.24 | $9.12 | $10.23 |
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 $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Emblem Health Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $190.55 | Professional | None | $112.20 | $147.91 | $190.55 |
Geisinger Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Geisinger Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $120.23 | Professional | None | $72.44 | $93.33 | $120.23 |
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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $102.33 | Professional | None | $79.43 | $91.20 | $102.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $45.71 Typical High $51.29 | Professional | 52 · Reduced service | $39.81 | $45.71 | $51.29 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $18.20 Typical High $20.42 | Professional | 53 · Discontinued | $15.85 | $18.20 | $20.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.80 Typical High $15.49 | Professional | 55 · Aftercare only | $12.02 | $13.80 | $15.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.12 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.94 | $9.12 | $10.23 |
Oscar Health Setting Professional Modifier None Typical Low $25.12 Median $144.54 Typical High $144.54 | Professional | None | $25.12 | $144.54 | $144.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $83.18 Median $380.19 Typical High $660.69 | Facility | None | $83.18 | $380.19 | $660.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $81.28 Median $83.18 Typical High $112.20 | Professional | None | $81.28 | $83.18 | $112.20 |
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 $58.88 Typical High $63.10 | Professional | None | $10.00 | $58.88 | $63.10 |
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 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· 8th of 51
$83.18
HI $135NY $41.69
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.