How much rates vary
Facilitymedian $35 · 10th to 90th $14 to $5,012Professionalmedian $14 · 10th to 90th $10 to $20
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 $15.49 Median $17.38 Typical High $17.38 | Facility | None | $15.49 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $17.38 | Professional | None | $14.13 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.76 Typical High $8.71 | Professional | 52 · Reduced service | $7.08 | $7.76 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.09 Typical High $3.47 | Professional | 53 · Discontinued | $2.82 | $3.09 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.34 Typical High $2.63 | Professional | 55 · Aftercare only | $2.14 | $2.34 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.55 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.41 | $1.55 | $1.74 |
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 $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Emblem Health Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $37.15 | Professional | None | $22.39 | $29.51 | $37.15 |
Geisinger Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Geisinger Setting Professional Modifier None Typical Low $12.30 Median $15.85 Typical High $20.42 | Professional | None | $12.30 | $15.85 | $20.42 |
Highmark BCBS Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Martin's Point Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Martin's Point Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $17.38 | Professional | None | $14.13 | $15.49 | $17.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.76 Typical High $8.71 | Professional | 52 · Reduced service | $7.08 | $7.76 | $8.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.09 Typical High $3.47 | Professional | 53 · Discontinued | $2.82 | $3.09 | $3.47 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.34 Typical High $2.63 | Professional | 55 · Aftercare only | $2.14 | $2.34 | $2.63 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.55 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.41 | $1.55 | $1.74 |
Oscar Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
UPMC Health Plan Setting Facility Modifier None Typical Low $14.13 Median $64.57 Typical High $112.20 | Facility | None | $14.13 | $64.57 | $112.20 |
UPMC Health Plan Setting Professional Modifier None Typical Low $13.80 Median $14.13 Typical High $19.05 | Professional | None | $13.80 | $14.13 | $19.05 |
United Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $32.36 | Facility | None | $26.92 | $26.92 | $32.36 |
United Setting Professional Modifier None Typical Low $6.03 Median $10.00 Typical High $12.30 | Professional | None | $6.03 | $10.00 | $12.30 |
5 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 BS Typical Low $7.08 Median $7.08 Typical High $15.14 | Professional | BS | $7.08 | $7.08 | $15.14 |
AmeriHealth Setting Professional Modifier PL · Progressive lenses Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | PL · Progressive lenses | $12.02 | $12.02 | $12.02 |
Independence Blue Cross Setting Professional Modifier BS Typical Low $7.08 Median $7.08 Typical High $15.14 | Professional | BS | $7.08 | $7.08 | $15.14 |
Independence Blue Cross Setting Professional Modifier PL · Progressive lenses Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | PL · Progressive lenses | $12.02 | $12.02 | $12.02 |
Oscar Health Setting Professional Modifier BS Typical Low $7.08 Median $7.08 Typical High $15.14 | Professional | BS | $7.08 | $7.08 | $15.14 |
Where Pennsylvania sits
The same service costs 3.2 times more in Montana 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· 35th of 51
$14.13
MT $26.92NY $8.32
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.