How much rates vary
Facilitymedian $1,259 · 10th to 90th $501 to $5,012Professionalmedian $912 · 10th to 90th $741 to $1,622
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 $758.58 Median $2,691.53 Typical High $8,511.38 | Facility | None | $758.58 | $2,691.53 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,202.26 | Professional | None | $724.44 | $851.14 | $1,202.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $602.56 | $630.96 |
AmeriHealth Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $977.24 | Professional | None | $912.01 | $912.01 | $977.24 |
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 $1,000.00 Median $1,023.29 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,023.29 | $2,398.83 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $1,698.24 |
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 $758.58 Median $891.25 Typical High $1,548.82 | Professional | None | $758.58 | $891.25 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $812.83 Median $1,202.26 Typical High $1,698.24 | Professional | None | $812.83 | $1,202.26 | $1,698.24 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $3,890.45 Typical High $8,128.31 | Facility | None | $1,148.15 | $3,890.45 | $8,128.31 |
Highmark BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,288.25 | Professional | None | $933.25 | $1,000.00 | $1,288.25 |
Independence Blue Cross Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $977.24 | Professional | None | $912.01 | $912.01 | $977.24 |
Martin's Point Setting Facility Modifier None Typical Low $758.58 Median $2,570.40 Typical High $8,317.64 | Facility | None | $758.58 | $2,570.40 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,230.27 | Professional | None | $724.44 | $851.14 | $1,230.27 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $602.56 | $630.96 |
Oscar Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,905.46 | Professional | None | $870.96 | $870.96 | $1,905.46 |
UPMC Health Plan Setting Facility Modifier None Typical Low $870.96 Median $1,096.48 Typical High $2,511.89 | Facility | None | $870.96 | $1,096.48 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,000.00 | Professional | None | $812.83 | $954.99 | $1,000.00 |
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 $758.58 Median $912.01 Typical High $1,659.59 | Professional | None | $758.58 | $912.01 | $1,659.59 |
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 $363.08 Median $426.58 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $91.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $426.58 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $426.58 | $457.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $169.82 | $181.97 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $645.65 | $676.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $134.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $91.20 |
Where Pennsylvania sits
The same service costs 4.4 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· 42nd of 51
$912
AK $3,311TX $759
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.