How much rates vary
Facilitymedian $617 · 10th to 90th $132 to $4,898Professionalmedian $355 · 10th to 90th $224 to $575
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 $295.12 Median $1,023.29 Typical High $6,606.93 | Facility | None | $295.12 | $1,023.29 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $467.74 | Professional | None | $213.80 | $346.74 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $213.80 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $147.91 | $213.80 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $338.84 Typical High $676.08 | Professional | None | $91.20 | $338.84 | $676.08 |
AmeriHealth Setting Facility Modifier None Typical Low $2,951.21 Median $3,715.35 Typical High $10,000.00 | Facility | None | $2,951.21 | $3,715.35 | $10,000.00 |
AmeriHealth Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | None | $323.59 | $380.19 | $380.19 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $56,234.13 | Facility | None | $2,511.89 | $2,570.40 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $933.25 | Professional | None | $380.19 | $398.11 | $933.25 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $316.23 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $309.03 | $316.23 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $588.84 Typical High $1,071.52 | Facility | None | $416.87 | $588.84 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $537.03 | Professional | None | $234.42 | $346.74 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Geisinger Setting Facility Modifier None Typical Low $389.05 Median $489.78 Typical High $870.96 | Facility | None | $389.05 | $489.78 | $870.96 |
Geisinger Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $660.69 | Professional | None | $316.23 | $457.09 | $660.69 |
Highmark BCBS Setting Facility Modifier None Typical Low $398.11 Median $1,445.44 Typical High $4,466.84 | Facility | None | $398.11 | $1,445.44 | $4,466.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $467.74 | Professional | None | $354.81 | $389.05 | $467.74 |
Independence Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $9,549.93 | Facility | None | $2,511.89 | $3,715.35 | $9,549.93 |
Independence Blue Cross Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Martin's Point Setting Facility Modifier None Typical Low $309.03 Median $1,513.56 Typical High $6,606.93 | Facility | None | $309.03 | $1,513.56 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $478.63 | Professional | None | $213.80 | $346.74 | $478.63 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $213.80 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $147.91 | $213.80 | $257.04 |
Oscar Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $776.25 | Professional | None | $331.13 | $331.13 | $776.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $263.03 Median $1,258.93 Typical High $2,884.03 | Facility | None | $263.03 | $1,258.93 | $2,884.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $389.05 | Professional | None | $239.88 | $354.81 | $389.05 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,698.24 | Facility | None | $77.62 | $158.49 | $1,698.24 |
United Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $575.44 | Professional | None | $229.09 | $354.81 | $575.44 |
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 $107.15 Median $151.36 Typical High $186.21 | Professional | 52 · Reduced service | $107.15 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $61.66 Typical High $74.13 | Professional | 53 · Discontinued | $42.66 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $158.49 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $31.62 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $21.38 | $30.20 | $37.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $154.88 Typical High $186.21 | Professional | 52 · Reduced service | $107.15 | $154.88 | $186.21 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $61.66 Typical High $74.13 | Professional | 53 · Discontinued | $42.66 | $61.66 | $74.13 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $158.49 | $229.09 | $275.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $31.62 | $45.71 | $54.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $30.90 Typical High $37.15 | Professional | 56 · Pre-op care only | $21.38 | $30.90 | $37.15 |
Where Pennsylvania sits
The same service costs 3.3 times more in Alaska than in Utah. 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
$372
AK $1,000UT $302
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.