How much rates vary
Facilitymedian $1,202 · 10th to 90th $513 to $5,012Professionalmedian $646 · 10th to 90th $490 to $977
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 $588.84 Median $3,235.94 Typical High $8,317.64 | Facility | None | $588.84 | $3,235.94 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $831.76 | Professional | None | $489.78 | $602.56 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $416.87 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $338.84 | $416.87 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
AmeriHealth Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $691.83 | Professional | None | $645.65 | $645.65 | $691.83 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $8,709.64 | Facility | None | $3,981.07 | $4,365.16 | $8,709.64 |
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 $489.78 Median $512.86 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,096.48 Typical High $2,187.76 | Facility | None | $501.19 | $1,096.48 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,071.52 | Professional | None | $512.86 | $645.65 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Geisinger Setting Facility Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,398.83 | Facility | None | $1,096.48 | $1,380.38 | $2,398.83 |
Geisinger Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,202.26 | Professional | None | $575.44 | $851.14 | $1,202.26 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,466.84 Typical High $10,232.93 | Facility | None | $2,137.96 | $4,466.84 | $10,232.93 |
Highmark BCBS Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $954.99 | Professional | None | $562.34 | $707.95 | $954.99 |
Independence Blue Cross Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $691.83 | Professional | None | $645.65 | $645.65 | $691.83 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,818.38 Typical High $7,244.36 | Facility | None | $588.84 | $2,818.38 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $851.14 | Professional | None | $489.78 | $602.56 | $851.14 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $426.58 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $338.84 | $426.58 | $446.68 |
Oscar Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,348.96 | Professional | None | $645.65 | $645.65 | $1,348.96 |
UPMC Health Plan Setting Facility Modifier None Typical Low $524.81 Median $1,230.27 Typical High $2,884.03 | Facility | None | $524.81 | $1,230.27 | $2,884.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $676.08 | Professional | None | $524.81 | $630.96 | $676.08 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,890.45 | Facility | None | $416.87 | $724.44 | $3,890.45 |
United Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,122.02 | Professional | None | $501.19 | $645.65 | $1,122.02 |
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 $239.88 Median $302.00 Typical High $323.59 | Professional | 52 · Reduced service | $239.88 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $120.23 Typical High $128.82 | Professional | 53 · Discontinued | $97.72 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $446.68 Typical High $478.63 | Professional | 54 · Surgery only | $363.08 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $91.20 Typical High $95.50 | Professional | 55 · Aftercare only | $72.44 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $60.26 Typical High $64.57 | Professional | 56 · Pre-op care only | $48.98 | $60.26 | $64.57 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $302.00 Typical High $323.59 | Professional | 52 · Reduced service | $239.88 | $302.00 | $323.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $120.23 Typical High $128.82 | Professional | 53 · Discontinued | $97.72 | $120.23 | $128.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $457.09 Typical High $478.63 | Professional | 54 · Surgery only | $363.08 | $457.09 | $478.63 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $91.20 Typical High $95.50 | Professional | 55 · Aftercare only | $72.44 | $91.20 | $95.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $60.26 Typical High $64.57 | Professional | 56 · Pre-op care only | $48.98 | $60.26 | $64.57 |
Where Pennsylvania sits
The same service costs 4.3 times more in Alaska than in Texas. 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· 40th of 51
$646
AK $2,291TX $537
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.