How much rates vary
Facilitymedian $141 · 10th to 90th $56 to $5,012Professionalmedian $56 · 10th to 90th $30 to $79
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 $61.66 Median $69.18 Typical High $69.18 | Facility | None | $61.66 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $69.18 | Professional | None | $48.98 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $30.90 Typical High $34.67 | Professional | 52 · Reduced service | $24.55 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.30 Typical High $13.80 | Professional | 53 · Discontinued | $10.00 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.33 Typical High $10.47 | Professional | 55 · Aftercare only | $7.41 | $9.33 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.17 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.01 | $6.17 | $6.92 |
AmeriHealth Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Emblem Health Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $154.88 | Professional | None | $91.20 | $120.23 | $154.88 |
Geisinger Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Geisinger Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $81.28 | Professional | None | $48.98 | $63.10 | $81.28 |
Highmark BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | None | $60.26 | $60.26 | $64.57 |
Independence Blue Cross Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Martin's Point Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Martin's Point Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $69.18 | Professional | None | $50.12 | $61.66 | $69.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $30.90 Typical High $34.67 | Professional | 52 · Reduced service | $26.30 | $30.90 | $34.67 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $12.30 Typical High $13.80 | Professional | 53 · Discontinued | $10.47 | $12.30 | $13.80 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $9.33 Typical High $10.47 | Professional | 55 · Aftercare only | $7.94 | $9.33 | $10.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.17 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.25 | $6.17 | $6.92 |
Oscar Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $39.81 | Professional | None | $34.67 | $34.67 | $39.81 |
UPMC Health Plan Setting Facility Modifier None Typical Low $56.23 Median $257.04 Typical High $446.68 | Facility | None | $56.23 | $257.04 | $446.68 |
UPMC Health Plan Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $75.86 | Professional | None | $54.95 | $56.23 | $75.86 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $100.00 | Facility | None | $83.18 | $83.18 | $100.00 |
United Setting Professional Modifier None Typical Low $12.02 Median $39.81 Typical High $42.66 | Professional | None | $12.02 | $39.81 | $42.66 |
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 2.8 times more in Montana than in Ohio. 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
$56.23
MT $83.18OH $30.20
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.