How much rates vary
Facilitymedian $437 · 10th to 90th $126 to $6,166Professionalmedian $195 · 10th to 90th $158 to $347
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 $186.21 Median $831.76 Typical High $5,888.44 | Facility | None | $186.21 | $831.76 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $288.40 | Professional | None | $158.49 | $186.21 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $125.89 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $112.20 | $125.89 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $446.68 | Professional | None | $177.83 | $181.97 | $446.68 |
AmeriHealth Setting Facility Modifier None Typical Low $131.83 Median $12,022.64 Typical High $26,302.68 | Facility | None | $131.83 | $12,022.64 | $26,302.68 |
AmeriHealth Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $208.93 | Professional | None | $194.98 | $194.98 | $208.93 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $489.78 | Professional | None | $208.93 | $218.78 | $489.78 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $173.78 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $169.82 | $173.78 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $302.00 Typical High $562.34 | Facility | None | $131.83 | $302.00 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $346.74 | Professional | None | $151.36 | $186.21 | $346.74 |
Emblem Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Geisinger Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $275.42 | Facility | None | $125.89 | $158.49 | $275.42 |
Geisinger Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $371.54 | Professional | None | $169.82 | $251.19 | $371.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $457.09 Median $1,071.52 Typical High $1,778.28 | Facility | None | $457.09 | $1,071.52 | $1,778.28 |
Highmark BCBS Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $251.19 | Professional | None | $181.97 | $208.93 | $251.19 |
Independence Blue Cross Setting Facility Modifier None Typical Low $131.83 Median $7,762.47 Typical High $26,302.68 | Facility | None | $131.83 | $7,762.47 | $26,302.68 |
Independence Blue Cross Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $208.93 | Professional | None | $194.98 | $194.98 | $208.93 |
Martin's Point Setting Facility Modifier None Typical Low $186.21 Median $891.25 Typical High $5,495.41 | Facility | None | $186.21 | $891.25 | $5,495.41 |
Martin's Point Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $302.00 | Professional | None | $158.49 | $186.21 | $302.00 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $125.89 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $112.20 | $125.89 | $138.04 |
Oscar Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $6,606.93 | Facility | None | $1,096.48 | $1,412.54 | $6,606.93 |
Oscar Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $363.08 | Professional | None | $186.21 | $186.21 | $363.08 |
UPMC Health Plan Setting Facility Modifier None Typical Low $154.88 Median $489.78 Typical High $1,122.02 | Facility | None | $154.88 | $489.78 | $1,122.02 |
UPMC Health Plan Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $208.93 | Professional | None | $154.88 | $177.83 | $208.93 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,348.96 | Facility | None | $77.62 | $158.49 | $1,348.96 |
United Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $354.81 | Professional | None | $154.88 | $190.55 | $354.81 |
10 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $91.20 Typical High $97.72 | Professional | 52 · Reduced service | $79.43 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $36.31 Typical High $38.90 | Professional | 53 · Discontinued | $31.62 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $134.90 Typical High $147.91 | Professional | 54 · Surgery only | $117.49 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.92 Typical High $29.51 | Professional | 55 · Aftercare only | $23.99 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $19.50 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $91.20 Typical High $97.72 | Professional | 52 · Reduced service | $79.43 | $91.20 | $97.72 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $36.31 Typical High $38.90 | Professional | 53 · Discontinued | $31.62 | $36.31 | $38.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $134.90 Typical High $147.91 | Professional | 54 · Surgery only | $117.49 | $134.90 | $147.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.92 Typical High $29.51 | Professional | 55 · Aftercare only | $23.99 | $26.92 | $29.51 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $19.50 |
Where Pennsylvania sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 45th of 51
$195
AK $759FL $174
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.