How much rates vary
Facilitymedian $224 · 10th to 90th $89 to $5,012Professionalmedian $89 · 10th to 90th $47 to $110
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 $97.72 Median $109.65 Typical High $109.65 | Facility | None | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $109.65 | Professional | None | $81.28 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $48.98 Typical High $54.95 | Professional | 52 · Reduced service | $39.81 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $19.50 Typical High $21.88 | Professional | 53 · Discontinued | $16.22 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.79 Typical High $16.60 | Professional | 55 · Aftercare only | $12.02 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.77 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.13 | $9.77 | $10.96 |
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 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $208.93 | Professional | None | $123.03 | $162.18 | $208.93 |
Geisinger Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Geisinger Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $128.82 | Professional | None | $75.86 | $97.72 | $128.82 |
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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Martin's Point Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $109.65 | Professional | None | $83.18 | $97.72 | $109.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $48.98 Typical High $54.95 | Professional | 52 · Reduced service | $40.74 | $48.98 | $54.95 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.50 Typical High $21.88 | Professional | 53 · Discontinued | $16.60 | $19.50 | $21.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $14.79 Typical High $16.60 | Professional | 55 · Aftercare only | $12.30 | $14.79 | $16.60 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.77 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.13 | $9.77 | $10.96 |
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 $89.13 Median $407.38 Typical High $691.83 | Facility | None | $89.13 | $407.38 | $691.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $87.10 Median $89.13 Typical High $120.23 | Professional | None | $87.10 | $89.13 | $120.23 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $158.49 | Facility | None | $131.83 | $131.83 | $158.49 |
United Setting Professional Modifier None Typical Low $15.14 Median $63.10 Typical High $67.61 | Professional | None | $15.14 | $63.10 | $67.61 |
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 2.5 times more in Montana than in Missouri. 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· 10th of 51
$89.13
MT $115MO $46.77
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.