How much rates vary
Facilitymedian $380 · 10th to 90th $89 to $6,026Professionalmedian $135 · 10th to 90th $89 to $214
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 $120.23 Median $831.76 Typical High $5,495.41 | Facility | None | $120.23 | $831.76 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $190.55 | Professional | None | $89.13 | $128.82 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $81.28 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $61.66 | $81.28 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | None | $147.91 | $158.49 | $158.49 |
AmeriHealth Setting Facility Modifier None Typical Low $1,659.59 Median $16,982.44 Typical High $25,703.96 | Facility | None | $1,659.59 | $16,982.44 | $25,703.96 |
AmeriHealth Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $151.36 | Professional | None | $141.25 | $141.25 | $151.36 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $8,709.64 | Facility | None | $1,202.26 | $1,258.93 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $309.03 | Professional | None | $154.88 | $154.88 | $309.03 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $123.03 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $117.49 | $123.03 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $125.89 Typical High $234.42 | Facility | None | $50.12 | $125.89 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $218.78 | Professional | None | $83.18 | $125.89 | $218.78 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Geisinger Setting Facility Modifier None Typical Low $109.65 Median $138.04 Typical High $239.88 | Facility | None | $109.65 | $138.04 | $239.88 |
Geisinger Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $263.03 | Professional | None | $107.15 | $177.83 | $263.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $263.03 Median $870.96 Typical High $1,905.46 | Facility | None | $263.03 | $870.96 | $1,905.46 |
Highmark BCBS Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | None | $138.04 | $151.36 | $151.36 |
Independence Blue Cross Setting Facility Modifier None Typical Low $1,513.56 Median $11,748.98 Typical High $25,703.96 | Facility | None | $1,513.56 | $11,748.98 | $25,703.96 |
Independence Blue Cross Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | None | $141.25 | $141.25 | $147.91 |
Martin's Point Setting Facility Modifier None Typical Low $123.03 Median $831.76 Typical High $4,897.79 | Facility | None | $123.03 | $831.76 | $4,897.79 |
Martin's Point Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $190.55 | Professional | None | $89.13 | $128.82 | $190.55 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $81.28 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $61.66 | $81.28 | $97.72 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $263.03 | Professional | None | $123.03 | $123.03 | $263.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $85.11 Median $194.98 Typical High $457.09 | Facility | None | $85.11 | $194.98 | $457.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $144.54 | Professional | None | $85.11 | $120.23 | $144.54 |
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 $91.20 Median $134.90 Typical High $223.87 | Professional | None | $91.20 | $134.90 | $223.87 |
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 $44.67 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $44.67 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $23.44 Typical High $27.54 | Professional | 53 · Discontinued | $17.78 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $87.10 Typical High $104.71 | Professional | 54 · Surgery only | $66.07 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $13.49 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.91 | $11.48 | $13.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $44.67 | $57.54 | $69.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $23.44 Typical High $27.54 | Professional | 53 · Discontinued | $17.78 | $23.44 | $27.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $87.10 Typical High $104.71 | Professional | 54 · Surgery only | $66.07 | $87.10 | $104.71 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $13.49 | $17.38 | $20.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.91 | $11.48 | $13.80 |
Where Pennsylvania sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 40th of 51
$138
AK $447KY $110
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.