How much rates vary
Facilitymedian $204 · 10th to 90th $81 to $5,012Professionalmedian $81 · 10th to 90th $42 to $115
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 $89.13 Median $100.00 Typical High $100.00 | Facility | None | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $100.00 | Professional | None | $74.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $44.67 Typical High $50.12 | Professional | 52 · Reduced service | $37.15 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $17.78 Typical High $19.95 | Professional | 53 · Discontinued | $14.79 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.18 Typical High $15.14 | Professional | 55 · Aftercare only | $10.96 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.91 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.41 | $8.91 | $10.00 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Emblem Health Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $181.97 | Professional | None | $91.20 | $141.25 | $181.97 |
Geisinger Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Geisinger Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $117.49 | Professional | None | $69.18 | $89.13 | $117.49 |
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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Martin's Point Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $100.00 | Professional | None | $81.28 | $89.13 | $100.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $44.67 Typical High $50.12 | Professional | 52 · Reduced service | $40.74 | $44.67 | $50.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $17.78 Typical High $19.95 | Professional | 53 · Discontinued | $16.22 | $17.78 | $19.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.18 Typical High $15.14 | Professional | 55 · Aftercare only | $12.02 | $13.18 | $15.14 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.91 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.13 | $8.91 | $10.00 |
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 $81.28 Median $371.54 Typical High $630.96 | Facility | None | $81.28 | $371.54 | $630.96 |
UPMC Health Plan Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $109.65 | Professional | None | $79.43 | $81.28 | $109.65 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $138.04 | Facility | None | $117.49 | $117.49 | $138.04 |
United Setting Professional Modifier None Typical Low $12.02 Median $56.23 Typical High $61.66 | Professional | None | $12.02 | $56.23 | $61.66 |
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 2.4 times more in Hawaii 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· 9th of 51
$81.28
HI $100OH $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.