How much rates vary
Facilitymedian $1,230 · 10th to 90th $513 to $5,129Professionalmedian $708 · 10th to 90th $562 to $1,096
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 $676.08 Median $3,801.89 Typical High $8,317.64 | Facility | None | $676.08 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $912.01 | Professional | None | $562.34 | $676.08 | $912.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $389.05 | $467.74 | $501.19 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,981.07 | $6,025.60 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $1,348.96 |
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 $588.84 Median $724.44 Typical High $1,230.27 | Professional | None | $588.84 | $724.44 | $1,230.27 |
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 $691.83 Median $977.24 Typical High $1,380.38 | Professional | None | $691.83 | $977.24 | $1,380.38 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $2,630.27 Typical High $8,709.64 | Facility | None | $1,548.82 | $2,630.27 | $8,709.64 |
Highmark BCBS Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $977.24 | Professional | None | $724.44 | $776.25 | $977.24 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $3,715.35 Typical High $8,317.64 | Facility | None | $724.44 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $891.25 | Professional | None | $562.34 | $676.08 | $891.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $389.05 | $478.63 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,548.82 | Professional | None | $758.58 | $758.58 | $1,548.82 |
UPMC Health Plan Setting Facility Modifier None Typical Low $562.34 Median $1,258.93 Typical High $2,884.03 | Facility | None | $562.34 | $1,258.93 | $2,884.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $758.58 | Professional | None | $562.34 | $645.65 | $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 $602.56 Median $724.44 Typical High $1,318.26 | Professional | None | $602.56 | $724.44 | $1,318.26 |
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 $281.84 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $281.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $112.20 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $416.87 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $85.11 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $72.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $281.84 | $338.84 | $354.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $112.20 | $134.90 | $144.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $512.86 Typical High $537.03 | Professional | 54 · Surgery only | $416.87 | $512.86 | $537.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $107.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $72.44 |
Where Pennsylvania sits
The same service costs 4.5 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
$724
AK $2,630TX $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.