How much rates vary
Facilitymedian $2,291 · 10th to 90th $851 to $6,166Professionalmedian $1,622 · 10th to 90th $1,514 to $2,754
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 $1,023.29 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,548.82 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,148.15 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,318.26 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,318.26 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,862.09 Typical High $3,162.28 | Facility | None | $616.60 | $1,862.09 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,621.81 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Geisinger Setting Facility Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $4,168.69 | Facility | None | $1,905.46 | $2,344.23 | $4,168.69 |
Geisinger Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,513.56 | $2,137.96 | $3,235.94 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,548.82 | $1,621.81 | $1,621.81 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,148.15 |
Oscar Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,862.09 | $1,862.09 | $3,311.31 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $4,265.80 | Facility | None | $1,548.82 | $2,137.96 | $4,265.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,621.81 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,819.70 | $3,388.44 |
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 $776.25 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $162.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $812.83 | $812.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $309.03 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,230.27 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $162.18 |
Where Pennsylvania sits
The same service costs 8.7 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· 46th of 51
$1,660
AK $7,244TX $832
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.