How much rates vary
Facilitymedian $155 · 10th to 90th $62 to $5,012Professionalmedian $62 · 10th to 90th $38 to $87
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 $67.61 Median $75.86 Typical High $75.86 | Facility | None | $67.61 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $75.86 | Professional | None | $61.66 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $33.88 Typical High $38.02 | Professional | 52 · Reduced service | $30.90 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.49 Typical High $15.14 | Professional | 53 · Discontinued | $12.30 | $13.49 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.23 Typical High $11.48 | Professional | 55 · Aftercare only | $9.33 | $10.23 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.76 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.17 | $6.76 | $7.59 |
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 $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $181.97 | Professional | None | $109.65 | $141.25 | $181.97 |
Geisinger Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Geisinger Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $89.13 | Professional | None | $53.70 | $69.18 | $89.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $75.86 | Professional | None | $61.66 | $67.61 | $75.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $33.88 Typical High $38.02 | Professional | 52 · Reduced service | $30.90 | $33.88 | $38.02 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.49 Typical High $15.14 | Professional | 53 · Discontinued | $12.30 | $13.49 | $15.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.23 Typical High $11.48 | Professional | 55 · Aftercare only | $9.33 | $10.23 | $11.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.76 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.17 | $6.76 | $7.59 |
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 $61.66 Median $281.84 Typical High $489.78 | Facility | None | $61.66 | $281.84 | $489.78 |
UPMC Health Plan Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $83.18 | Professional | None | $60.26 | $61.66 | $83.18 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $125.89 | Facility | None | $104.71 | $104.71 | $125.89 |
United Setting Professional Modifier None Typical Low $15.14 Median $43.65 Typical High $46.77 | Professional | None | $15.14 | $43.65 | $46.77 |
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 2.7 times more in Hawaii than in Utah. 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· 22nd of 51
$61.66
HI $102UT $38.02
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.