How much rates vary
Facilitymedian $447 · 10th to 90th $100 to $3,802Professionalmedian $339 · 10th to 90th $219 to $501
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 $363.08 Median $2,454.71 Typical High $8,317.64 | Facility | None | $363.08 | $2,454.71 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $457.09 | Professional | None | $208.93 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $194.98 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $144.54 | $194.98 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | None | $660.69 | $660.69 | $707.95 |
AmeriHealth Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $389.05 | Professional | None | $371.54 | $371.54 | $389.05 |
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 $56,234.13 Median $56,234.13 Typical High $56,234.13 | Professional | None | $56,234.13 | $56,234.13 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $316.23 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $302.00 | $316.23 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $436.52 Typical High $794.33 | Facility | None | $239.88 | $436.52 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $524.81 | Professional | None | $229.09 | $323.59 | $524.81 |
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 $218.78 Median $269.15 Typical High $478.63 | Facility | None | $218.78 | $269.15 | $478.63 |
Geisinger Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $645.65 | Professional | None | $302.00 | $446.68 | $645.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $223.87 Median $812.83 Typical High $2,238.72 | Facility | None | $223.87 | $812.83 | $2,238.72 |
Highmark BCBS Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $436.52 | Professional | None | $354.81 | $380.19 | $436.52 |
Independence Blue Cross Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Martin's Point Setting Facility Modifier None Typical Low $363.08 Median $2,290.87 Typical High $7,244.36 | Facility | None | $363.08 | $2,290.87 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $457.09 | Professional | None | $208.93 | $338.84 | $457.09 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $194.98 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $144.54 | $194.98 | $251.19 |
Oscar Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $707.95 | Professional | None | $331.13 | $331.13 | $707.95 |
UPMC Health Plan Setting Facility Modifier None Typical Low $257.04 Median $1,096.48 Typical High $2,511.89 | Facility | None | $257.04 | $1,096.48 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $380.19 | Professional | None | $234.42 | $323.59 | $380.19 |
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 $223.87 Median $346.74 Typical High $549.54 | Professional | None | $223.87 | $346.74 | $549.54 |
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 $104.71 Median $141.25 Typical High $177.83 | Professional | 52 · Reduced service | $104.71 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $56.23 Typical High $72.44 | Professional | 53 · Discontinued | $41.69 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $208.93 Typical High $269.15 | Professional | 54 · Surgery only | $154.88 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $41.69 Typical High $53.70 | Professional | 55 · Aftercare only | $30.90 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $28.18 Typical High $36.31 | Professional | 56 · Pre-op care only | $20.89 | $28.18 | $36.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $141.25 Typical High $177.83 | Professional | 52 · Reduced service | $104.71 | $141.25 | $177.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $56.23 Typical High $72.44 | Professional | 53 · Discontinued | $41.69 | $56.23 | $72.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $208.93 Typical High $269.15 | Professional | 54 · Surgery only | $154.88 | $208.93 | $269.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $41.69 Typical High $53.70 | Professional | 55 · Aftercare only | $30.90 | $41.69 | $53.70 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $28.18 Typical High $36.31 | Professional | 56 · Pre-op care only | $20.89 | $28.18 | $36.31 |
Where Pennsylvania sits
The same service costs 3.5 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· 39th of 51
$339
AK $977MD $282
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.