How much rates vary
Facilitymedian $151 · 10th to 90th $60 to $5,012Professionalmedian $59 · 10th to 90th $31 to $83
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 $66.07 Median $74.13 Typical High $74.13 | Facility | None | $66.07 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $74.13 | Professional | None | $54.95 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $32.36 Typical High $36.31 | Professional | 52 · Reduced service | $27.54 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.18 Typical High $14.79 | Professional | 53 · Discontinued | $10.96 | $13.18 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.77 Typical High $10.96 | Professional | 55 · Aftercare only | $8.32 | $9.77 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.46 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.50 | $6.46 | $7.41 |
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 $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Emblem Health Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $158.49 | Professional | None | $93.33 | $123.03 | $158.49 |
Geisinger Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Geisinger Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $85.11 | Professional | None | $51.29 | $66.07 | $85.11 |
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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Martin's Point Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $74.13 | Professional | None | $58.88 | $66.07 | $74.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $32.36 Typical High $36.31 | Professional | 52 · Reduced service | $29.51 | $32.36 | $36.31 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.18 Typical High $14.79 | Professional | 53 · Discontinued | $12.02 | $13.18 | $14.79 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.77 Typical High $10.96 | Professional | 55 · Aftercare only | $8.91 | $9.77 | $10.96 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.46 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.89 | $6.46 | $7.41 |
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 $60.26 Median $275.42 Typical High $467.74 | Facility | None | $60.26 | $275.42 | $467.74 |
UPMC Health Plan Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $79.43 | Professional | None | $57.54 | $60.26 | $79.43 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $102.33 | Facility | None | $85.11 | $85.11 | $102.33 |
United Setting Professional Modifier None Typical Low $15.14 Median $41.69 Typical High $45.71 | Professional | None | $15.14 | $41.69 | $45.71 |
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 4.2 times more in Minnesota than in Alaska. 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
$58.88
MN $85.11AK $20.42
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.