How much rates vary
Facilitymedian $166 · 10th to 90th $68 to $5,012Professionalmedian $66 · 10th to 90th $35 to $81
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 $72.44 Median $81.28 Typical High $81.28 | Facility | None | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $81.28 | Professional | None | $58.88 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $36.31 Typical High $40.74 | Professional | 52 · Reduced service | $29.51 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $14.45 Typical High $16.22 | Professional | 53 · Discontinued | $11.75 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.96 Typical High $12.30 | Professional | 55 · Aftercare only | $8.91 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.24 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.89 | $7.24 | $8.13 |
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 $74.13 Median $74.13 Typical High $85.11 | Professional | None | $74.13 | $74.13 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Emblem Health Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $173.78 | Professional | None | $104.71 | $138.04 | $173.78 |
Geisinger Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Geisinger Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $95.50 | Professional | None | $57.54 | $74.13 | $95.50 |
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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Martin's Point Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $81.28 | Professional | None | $61.66 | $72.44 | $81.28 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $36.31 Typical High $40.74 | Professional | 52 · Reduced service | $30.90 | $36.31 | $40.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.45 Typical High $16.22 | Professional | 53 · Discontinued | $12.30 | $14.45 | $16.22 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.96 Typical High $12.30 | Professional | 55 · Aftercare only | $9.12 | $10.96 | $12.30 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.24 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.17 | $7.24 | $8.13 |
Oscar Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $58.88 | Professional | None | $34.67 | $34.67 | $58.88 |
UPMC Health Plan Setting Facility Modifier None Typical Low $67.61 Median $302.00 Typical High $524.81 | Facility | None | $67.61 | $302.00 | $524.81 |
UPMC Health Plan Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $89.13 | Professional | None | $64.57 | $67.61 | $89.13 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $114.82 | Facility | None | $95.50 | $95.50 | $114.82 |
United Setting Professional Modifier None Typical Low $12.02 Median $46.77 Typical High $50.12 | Professional | None | $12.02 | $46.77 | $50.12 |
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 2.9 times more in Montana than in Nebraska. 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· 9th of 51
$66.07
MT $100NE $34.67
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.