How much rates vary
Facilitymedian $288 · 10th to 90th $115 to $5,012Professionalmedian $115 · 10th to 90th $63 to $162
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 $125.89 Median $141.25 Typical High $141.25 | Facility | None | $125.89 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $141.25 | Professional | None | $104.71 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $63.10 Typical High $70.79 | Professional | 52 · Reduced service | $52.48 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.12 Typical High $28.18 | Professional | 53 · Discontinued | $21.38 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $21.38 | Professional | 55 · Aftercare only | $15.85 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.59 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.47 | $12.59 | $14.13 |
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 $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Emblem Health Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $263.03 | Professional | None | $154.88 | $204.17 | $263.03 |
Geisinger Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Geisinger Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $165.96 | Professional | None | $97.72 | $125.89 | $165.96 |
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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $141.25 | Professional | None | $114.82 | $125.89 | $141.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $63.10 Typical High $70.79 | Professional | 52 · Reduced service | $57.54 | $63.10 | $70.79 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.12 Typical High $28.18 | Professional | 53 · Discontinued | $22.91 | $25.12 | $28.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.05 Typical High $21.38 | Professional | 55 · Aftercare only | $16.98 | $19.05 | $21.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.59 Typical High $14.13 | Professional | 56 · Pre-op care only | $11.48 | $12.59 | $14.13 |
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 $114.82 Median $524.81 Typical High $891.25 | Facility | None | $114.82 | $524.81 | $891.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $154.88 | Professional | None | $112.20 | $114.82 | $154.88 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $208.93 | Facility | None | $173.78 | $173.78 | $208.93 |
United Setting Professional Modifier None Typical Low $15.14 Median $81.28 Typical High $87.10 | Professional | None | $15.14 | $81.28 | $87.10 |
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· 9th of 51
$115
HI $170NY $58.88
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.