How much rates vary
Facilitymedian $182 · 10th to 90th $72 to $5,012Professionalmedian $72 · 10th to 90th $40 to $102
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 $79.43 Median $89.13 Typical High $89.13 | Facility | None | $79.43 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $89.13 | Professional | None | $67.61 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $39.81 Typical High $44.67 | Professional | 52 · Reduced service | $33.11 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.85 Typical High $17.78 | Professional | 53 · Discontinued | $13.49 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.02 Typical High $13.49 | Professional | 55 · Aftercare only | $10.00 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.94 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.76 | $7.94 | $8.91 |
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 $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $194.98 | Professional | None | $100.00 | $154.88 | $194.98 |
Geisinger Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Geisinger Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $104.71 | Professional | None | $61.66 | $79.43 | $104.71 |
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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $89.13 | Professional | None | $70.79 | $79.43 | $89.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $39.81 Typical High $44.67 | Professional | 52 · Reduced service | $35.48 | $39.81 | $44.67 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.85 Typical High $17.78 | Professional | 53 · Discontinued | $14.13 | $15.85 | $17.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.02 Typical High $13.49 | Professional | 55 · Aftercare only | $10.72 | $12.02 | $13.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.94 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.08 | $7.94 | $8.91 |
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 $72.44 Median $331.13 Typical High $562.34 | Facility | None | $72.44 | $331.13 | $562.34 |
UPMC Health Plan Setting Professional Modifier None Typical Low $70.79 Median $72.44 Typical High $97.72 | Professional | None | $70.79 | $72.44 | $97.72 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $131.83 | Facility | None | $109.65 | $109.65 | $131.83 |
United Setting Professional Modifier None Typical Low $15.14 Median $51.29 Typical High $54.95 | Professional | None | $15.14 | $51.29 | $54.95 |
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 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· 11th of 51
$72.44
HI $107OH $39.81
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.