How much rates vary
Facilitymedian $240 · 10th to 90th $95 to $5,012Professionalmedian $95 · 10th to 90th $49 to $135
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 $104.71 Median $117.49 Typical High $117.49 | Facility | None | $104.71 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $117.49 | Professional | None | $83.18 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $52.48 Typical High $58.88 | Professional | 52 · Reduced service | $41.69 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $20.89 Typical High $23.44 | Professional | 53 · Discontinued | $16.60 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.49 Typical High $17.78 | Professional | 55 · Aftercare only | $12.59 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.47 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.32 | $10.47 | $11.75 |
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 $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Emblem Health Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $239.88 | Professional | None | $144.54 | $190.55 | $239.88 |
Geisinger Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Geisinger Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $138.04 | Professional | None | $81.28 | $104.71 | $138.04 |
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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Martin's Point Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $117.49 | Professional | None | $89.13 | $104.71 | $117.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $52.48 Typical High $58.88 | Professional | 52 · Reduced service | $44.67 | $52.48 | $58.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.89 Typical High $23.44 | Professional | 53 · Discontinued | $17.78 | $20.89 | $23.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.49 Typical High $17.78 | Professional | 55 · Aftercare only | $13.18 | $15.49 | $17.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.47 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.91 | $10.47 | $11.75 |
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 $95.50 Median $436.52 Typical High $741.31 | Facility | None | $95.50 | $436.52 | $741.31 |
UPMC Health Plan Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $128.82 | Professional | None | $93.33 | $95.50 | $128.82 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $162.18 | Facility | None | $138.04 | $138.04 | $162.18 |
United Setting Professional Modifier None Typical Low $12.02 Median $67.61 Typical High $72.44 | Professional | None | $12.02 | $67.61 | $72.44 |
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 2.6 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
$95.50
HI $126OH $48.98
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.