How much rates vary
Facilitymedian $589 · 10th to 90th $100 to $4,266Professionalmedian $372 · 10th to 90th $240 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 $389.05 Median $3,630.78 Typical High $7,943.28 | Facility | None | $389.05 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $501.19 | Professional | None | $239.88 | $371.54 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $223.87 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $165.96 | $223.87 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $630.96 Typical High $630.96 | Professional | None | $363.08 | $630.96 | $630.96 |
AmeriHealth Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | None | $199.53 | $199.53 | $213.80 |
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 $602.56 Median $676.08 Typical High $741.31 | Professional | None | $602.56 | $676.08 | $741.31 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $338.84 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $331.13 | $338.84 | $794.33 |
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 $263.03 Median $363.08 Typical High $602.56 | Professional | None | $263.03 | $363.08 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $338.84 Median $501.19 Typical High $707.95 | Professional | None | $338.84 | $501.19 | $707.95 |
Highmark BCBS Setting Facility Modifier None Typical Low $457.09 Median $1,659.59 Typical High $3,090.30 | Facility | None | $457.09 | $1,659.59 | $3,090.30 |
Highmark BCBS Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $446.68 | Professional | None | $389.05 | $416.87 | $446.68 |
Independence Blue Cross Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Martin's Point Setting Facility Modifier None Typical Low $389.05 Median $3,630.78 Typical High $7,244.36 | Facility | None | $389.05 | $3,630.78 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $501.19 | Professional | None | $239.88 | $371.54 | $501.19 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $223.87 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $165.96 | $223.87 | $275.42 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $794.33 | Professional | None | $416.87 | $416.87 | $794.33 |
UPMC Health Plan Setting Facility Modifier None Typical Low $316.23 Median $1,230.27 Typical High $2,884.03 | Facility | None | $316.23 | $1,230.27 | $2,884.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $407.38 | Professional | None | $269.15 | $398.11 | $407.38 |
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 $257.04 Median $389.05 Typical High $630.96 | Professional | None | $257.04 | $389.05 | $630.96 |
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 $120.23 Median $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $120.23 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $239.88 Typical High $295.12 | Professional | 54 · Surgery only | $177.83 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $48.98 Typical High $58.88 | Professional | 55 · Aftercare only | $36.31 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.99 | $32.36 | $38.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $120.23 | $162.18 | $194.98 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $64.57 | $77.62 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $239.88 Typical High $295.12 | Professional | 54 · Surgery only | $177.83 | $239.88 | $295.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $48.98 Typical High $58.88 | Professional | 55 · Aftercare only | $36.31 | $48.98 | $58.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.99 | $32.36 | $38.90 |
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
$372
AK $1,122KY $331
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.