How much rates vary
Facilitymedian $1,230 · 10th to 90th $501 to $4,898Professionalmedian $708 · 10th to 90th $537 to $1,202
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 $645.65 Median $2,818.38 Typical High $8,511.38 | Facility | None | $645.65 | $2,818.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $912.01 | Professional | None | $524.81 | $660.69 | $912.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $363.08 | $457.09 | $489.78 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $56,234.13 | Facility | None | $3,981.07 | $4,365.16 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,819.70 | Professional | None | $758.58 | $794.33 | $1,819.70 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,071.52 Typical High $1,862.09 | Facility | None | $478.63 | $1,071.52 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,174.90 | Professional | None | $562.34 | $691.83 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $660.69 Median $933.25 Typical High $1,348.96 | Professional | None | $660.69 | $933.25 | $1,348.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $977.24 Median $4,897.79 Typical High $9,772.37 | Facility | None | $977.24 | $4,897.79 | $9,772.37 |
Highmark BCBS Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,047.13 | Professional | None | $741.31 | $776.25 | $1,047.13 |
Martin's Point Setting Facility Modifier None Typical Low $707.95 Median $2,630.27 Typical High $8,511.38 | Facility | None | $707.95 | $2,630.27 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $912.01 | Professional | None | $524.81 | $660.69 | $912.01 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $467.74 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $363.08 | $467.74 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,479.11 | Professional | None | $758.58 | $758.58 | $1,479.11 |
UPMC Health Plan Setting Facility Modifier None Typical Low $616.60 Median $1,096.48 Typical High $2,511.89 | Facility | None | $616.60 | $1,096.48 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $758.58 | Professional | None | $588.84 | $724.44 | $758.58 |
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 $549.54 Median $707.95 Typical High $1,230.27 | Professional | None | $549.54 | $707.95 | $1,230.27 |
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 $263.03 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $263.03 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $104.71 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $489.78 Typical High $524.81 | Professional | 54 · Surgery only | $389.05 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $97.72 Typical High $104.71 | Professional | 55 · Aftercare only | $77.62 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $52.48 | $66.07 | $70.79 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $263.03 | $331.13 | $354.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $104.71 | $131.83 | $141.25 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $389.05 | $501.19 | $524.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $77.62 | $100.00 | $104.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $52.48 | $66.07 | $70.79 |
Where Pennsylvania sits
The same service costs 4.2 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· 43rd of 51
$708
AK $2,455TX $589
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.