How much rates vary
Facilitymedian $380 · 10th to 90th $87 to $5,888Professionalmedian $214 · 10th to 90th $123 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 $177.83 Median $912.01 Typical High $6,165.95 | Facility | None | $177.83 | $912.01 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $309.03 | Professional | None | $123.03 | $223.87 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $128.82 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $87.10 | $128.82 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
AmeriHealth Setting Facility Modifier None Typical Low $707.95 Median $7,413.10 Typical High $10,715.19 | Facility | None | $707.95 | $7,413.10 | $10,715.19 |
AmeriHealth Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | None | $123.03 | $123.03 | $131.83 |
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 $407.38 Median $407.38 Typical High $56,234.13 | Professional | None | $407.38 | $407.38 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $213.80 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $204.17 | $213.80 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $204.17 Typical High $380.19 | Facility | None | $50.12 | $204.17 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $331.13 | Professional | None | $138.04 | $213.80 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Geisinger Setting Facility Modifier None Typical Low $181.97 Median $229.09 Typical High $398.11 | Facility | None | $181.97 | $229.09 | $398.11 |
Geisinger Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $436.52 | Professional | None | $181.97 | $288.40 | $436.52 |
Highmark BCBS Setting Facility Modifier None Typical Low $309.03 Median $724.44 Typical High $1,479.11 | Facility | None | $309.03 | $724.44 | $1,479.11 |
Highmark BCBS Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $354.81 | Professional | None | $158.49 | $257.04 | $354.81 |
Independence Blue Cross Setting Facility Modifier None Typical Low $691.83 Median $5,888.44 Typical High $12,589.25 | Facility | None | $691.83 | $5,888.44 | $12,589.25 |
Independence Blue Cross Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | None | $123.03 | $123.03 | $131.83 |
Martin's Point Setting Facility Modifier None Typical Low $190.55 Median $1,023.29 Typical High $5,888.44 | Facility | None | $190.55 | $1,023.29 | $5,888.44 |
Martin's Point Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $316.23 | Professional | None | $123.03 | $229.09 | $316.23 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $128.82 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $87.10 | $128.82 | $173.78 |
Oscar Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $489.78 | Professional | None | $223.87 | $223.87 | $489.78 |
UPMC Health Plan Setting Facility Modifier None Typical Low $147.91 Median $257.04 Typical High $436.52 | Facility | None | $147.91 | $257.04 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $257.04 | Professional | None | $141.25 | $223.87 | $257.04 |
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 $134.90 Median $223.87 Typical High $354.81 | Professional | None | $134.90 | $223.87 | $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 $61.66 Median $93.33 Typical High $123.03 | Professional | 52 · Reduced service | $61.66 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $37.15 Typical High $48.98 | Professional | 53 · Discontinued | $24.55 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $138.04 Typical High $186.21 | Professional | 54 · Surgery only | $93.33 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $18.62 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.62 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.30 | $18.62 | $24.55 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $93.33 Typical High $123.03 | Professional | 52 · Reduced service | $61.66 | $93.33 | $123.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $37.15 Typical High $48.98 | Professional | 53 · Discontinued | $24.55 | $37.15 | $48.98 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $138.04 Typical High $186.21 | Professional | 54 · Surgery only | $93.33 | $138.04 | $186.21 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $18.62 | $28.18 | $37.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.62 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.30 | $18.62 | $24.55 |
Where Pennsylvania sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 38th of 51
$224
AK $631MD $186
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.