How much rates vary
Facilitymedian $200 · 10th to 90th $79 to $5,012Professionalmedian $79 · 10th to 90th $46 to $112
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 $87.10 Median $97.72 Typical High $97.72 | Facility | None | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $97.72 | Professional | None | $74.13 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $43.65 Typical High $48.98 | Professional | 52 · Reduced service | $37.15 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $17.38 Typical High $19.50 | Professional | 53 · Discontinued | $14.79 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $14.79 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.71 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.41 | $8.71 | $9.77 |
AmeriHealth Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $181.97 | Professional | None | $109.65 | $144.54 | $181.97 |
Geisinger Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Geisinger Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $114.82 | Professional | None | $67.61 | $87.10 | $114.82 |
Independence Blue Cross Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Martin's Point Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $97.72 | Professional | None | $77.62 | $87.10 | $97.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $43.65 Typical High $48.98 | Professional | 52 · Reduced service | $38.90 | $43.65 | $48.98 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $17.38 Typical High $19.50 | Professional | 53 · Discontinued | $15.49 | $17.38 | $19.50 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.88 Typical High $14.79 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $14.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.71 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.76 | $8.71 | $9.77 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
UPMC Health Plan Setting Facility Modifier None Typical Low $79.43 Median $363.08 Typical High $616.60 | Facility | None | $79.43 | $363.08 | $616.60 |
UPMC Health Plan Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $107.15 | Professional | None | $77.62 | $79.43 | $107.15 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $151.36 | Facility | None | $125.89 | $125.89 | $151.36 |
United Setting Professional Modifier None Typical Low $15.14 Median $56.23 Typical High $60.26 | Professional | None | $15.14 | $56.23 | $60.26 |
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 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· 15th of 51
$79.43
HI $120NY $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.