How much rates vary
Facilitymedian $457 · 10th to 90th $112 to $3,715Professionalmedian $138 · 10th to 90th $93 to $224
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 $117.49 Median $1,096.48 Typical High $7,244.36 | Facility | None | $117.49 | $1,096.48 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $194.98 | Professional | None | $93.33 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $87.10 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $66.07 | $87.10 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $190.55 | Professional | None | $147.91 | $151.36 | $190.55 |
AmeriHealth Setting Facility Modifier None Typical Low $53.70 Median $707.95 Typical High $6,309.57 | Facility | None | $53.70 | $707.95 | $6,309.57 |
AmeriHealth Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $125.89 | Professional | None | $74.13 | $74.13 | $125.89 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,630.27 Median $2,818.38 Typical High $8,709.64 | Facility | None | $2,630.27 | $2,818.38 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $371.54 | Professional | None | $154.88 | $162.18 | $371.54 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $128.82 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $125.89 | $128.82 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $295.12 Typical High $549.54 | Facility | None | $114.82 | $295.12 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $213.80 | Professional | None | $97.72 | $138.04 | $213.80 |
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 $102.33 Median $128.82 Typical High $229.09 | Facility | None | $102.33 | $128.82 | $229.09 |
Geisinger Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $269.15 | Professional | None | $128.82 | $186.21 | $269.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $141.25 Median $1,479.11 Typical High $3,311.31 | Facility | None | $141.25 | $1,479.11 | $3,311.31 |
Highmark BCBS Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $169.82 | Professional | None | $123.03 | $147.91 | $169.82 |
Independence Blue Cross Setting Facility Modifier None Typical Low $478.63 Median $707.95 Typical High $7,762.47 | Facility | None | $478.63 | $707.95 | $7,762.47 |
Independence Blue Cross Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $125.89 | Professional | None | $74.13 | $74.13 | $125.89 |
Martin's Point Setting Facility Modifier None Typical Low $144.54 Median $1,479.11 Typical High $6,606.93 | Facility | None | $144.54 | $1,479.11 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $194.98 | Professional | None | $93.33 | $138.04 | $194.98 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $87.10 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $66.07 | $87.10 | $104.71 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $295.12 | Professional | None | $162.18 | $162.18 | $295.12 |
UPMC Health Plan Setting Facility Modifier None Typical Low $100.00 Median $812.83 Typical High $1,862.09 | Facility | None | $100.00 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $154.88 | Professional | None | $100.00 | $134.90 | $154.88 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $2,089.30 | Facility | None | $199.53 | $436.52 | $2,089.30 |
United Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $239.88 | Professional | None | $97.72 | $144.54 | $239.88 |
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 $46.77 Median $61.66 Typical High $74.13 | Professional | 52 · Reduced service | $46.77 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $24.55 Typical High $29.51 | Professional | 53 · Discontinued | $18.62 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $93.33 Typical High $112.20 | Professional | 54 · Surgery only | $70.79 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.62 Typical High $22.39 | Professional | 55 · Aftercare only | $14.13 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.30 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.33 | $12.30 | $14.79 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $61.66 Typical High $74.13 | Professional | 52 · Reduced service | $46.77 | $61.66 | $74.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $24.55 Typical High $29.51 | Professional | 53 · Discontinued | $18.62 | $24.55 | $29.51 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $93.33 Typical High $112.20 | Professional | 54 · Surgery only | $70.79 | $93.33 | $112.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.62 Typical High $22.39 | Professional | 55 · Aftercare only | $14.13 | $18.62 | $22.39 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.30 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.33 | $12.30 | $14.79 |
Where Pennsylvania sits
The same service costs 3.5 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· 42nd of 51
$148
AK $447FL $126
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.