How much rates vary
Facilitymedian $417 · 10th to 90th $174 to $2,884Professionalmedian $219 · 10th to 90th $145 to $324
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 $213.80 Median $1,584.89 Typical High $6,165.95 | Facility | None | $213.80 | $1,584.89 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $302.00 | Professional | None | $144.54 | $218.78 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $134.90 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $102.33 | $134.90 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
AmeriHealth Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Professional | None | $117.49 | $117.49 | $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 $257.04 Median $257.04 Typical High $323.59 | Professional | None | $257.04 | $257.04 | $323.59 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $204.17 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $199.53 | $204.17 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $323.59 Typical High $549.54 | Facility | None | $173.78 | $323.59 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $338.84 | Professional | None | $144.54 | $218.78 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Geisinger Setting Facility Modifier None Typical Low $158.49 Median $199.53 Typical High $346.74 | Facility | None | $158.49 | $199.53 | $346.74 |
Geisinger Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $416.87 | Professional | None | $186.21 | $295.12 | $416.87 |
Highmark BCBS Setting Facility Modifier None Typical Low $104.71 Median $1,258.93 Typical High $3,388.44 | Facility | None | $104.71 | $1,258.93 | $3,388.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $288.40 | Professional | None | $223.87 | $251.19 | $288.40 |
Independence Blue Cross Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $120.23 | Professional | None | $117.49 | $117.49 | $120.23 |
Martin's Point Setting Facility Modifier None Typical Low $234.42 Median $1,819.70 Typical High $6,165.95 | Facility | None | $234.42 | $1,819.70 | $6,165.95 |
Martin's Point Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $302.00 | Professional | None | $144.54 | $218.78 | $302.00 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $134.90 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $102.33 | $134.90 | $162.18 |
Oscar Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $489.78 | Professional | None | $234.42 | $234.42 | $489.78 |
UPMC Health Plan Setting Facility Modifier None Typical Low $154.88 Median $1,096.48 Typical High $2,511.89 | Facility | None | $154.88 | $1,096.48 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $245.47 | Professional | None | $154.88 | $223.87 | $245.47 |
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 $151.36 Median $223.87 Typical High $371.54 | Professional | None | $151.36 | $223.87 | $371.54 |
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 $72.44 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $72.44 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $28.84 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $109.65 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $21.88 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.45 | $19.50 | $23.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $72.44 | $97.72 | $117.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $28.84 | $38.90 | $46.77 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $109.65 | $144.54 | $173.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $21.88 | $28.84 | $34.67 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.45 | $19.50 | $23.44 |
Where Pennsylvania sits
The same service costs 3.4 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· 43rd of 51
$224
AK $692KY $204
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.