How much rates vary
Facilitymedian $295 · 10th to 90th $110 to $5,012Professionalmedian $100 · 10th to 90th $63 to $141
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 $109.65 Median $123.03 Typical High $123.03 | Facility | None | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $123.03 | Professional | None | $100.00 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $50.12 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $19.95 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.00 | $10.96 | $12.30 |
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 $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $323.59 | Professional | None | $190.55 | $251.19 | $323.59 |
Geisinger Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Geisinger Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $144.54 | Professional | None | $87.10 | $100.00 | $144.54 |
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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $123.03 | Professional | None | $100.00 | $109.65 | $123.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $50.12 | $54.95 | $61.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $24.55 | Professional | 53 · Discontinued | $19.95 | $21.88 | $24.55 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $16.60 | $18.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.00 | $10.96 | $12.30 |
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 $100.00 Median $457.09 Typical High $794.33 | Facility | None | $100.00 | $457.09 | $794.33 |
UPMC Health Plan Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $229.09 | Facility | None | $190.55 | $190.55 | $229.09 |
United Setting Professional Modifier None Typical Low $15.14 Median $70.79 Typical High $75.86 | Professional | None | $15.14 | $70.79 | $75.86 |
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 3.0 times more in Hawaii than in Indiana. 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· 28th of 51
$100
HI $204IN $69.18
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.