How much rates vary
Facilitymedian $447 · 10th to 90th $68 to $19,953Professionalmedian $98 · 10th to 90th $58 to $162
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 $79.43 Median $891.25 Typical High $6,165.95 | Facility | None | $79.43 | $891.25 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $138.04 | Professional | None | $57.54 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $39.81 Median $60.26 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $39.81 | $60.26 | $74.13 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $104.71 Typical High $169.82 | Professional | None | $85.11 | $104.71 | $169.82 |
AmeriHealth Setting Facility Modifier None Typical Low $12,302.69 Median $30,902.95 Typical High $46,773.51 | Facility | None | $12,302.69 | $30,902.95 | $46,773.51 |
AmeriHealth Setting Professional Modifier None Typical Low $52.48 Median $60.26 Typical High $104.71 | Professional | None | $52.48 | $60.26 | $104.71 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $257.04 | Professional | None | $109.65 | $114.82 | $257.04 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $91.20 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $87.10 | $91.20 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $120.23 | Facility | None | $50.12 | $66.07 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $147.91 | Professional | None | $54.95 | $91.20 | $147.91 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Geisinger Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $181.97 | Professional | None | $75.86 | $125.89 | $181.97 |
Highmark BCBS Setting Facility Modifier None Typical Low $213.80 Median $537.03 Typical High $1,230.27 | Facility | None | $213.80 | $537.03 | $1,230.27 |
Highmark BCBS Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $177.83 | Professional | None | $89.13 | $117.49 | $177.83 |
Independence Blue Cross Setting Facility Modifier None Typical Low $6,025.60 Median $21,379.62 Typical High $46,773.51 | Facility | None | $6,025.60 | $21,379.62 | $46,773.51 |
Independence Blue Cross Setting Professional Modifier None Typical Low $52.48 Median $60.26 Typical High $104.71 | Professional | None | $52.48 | $60.26 | $104.71 |
Martin's Point Setting Facility Modifier None Typical Low $91.20 Median $1,047.13 Typical High $6,165.95 | Facility | None | $91.20 | $1,047.13 | $6,165.95 |
Martin's Point Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $141.25 | Professional | None | $57.54 | $97.72 | $141.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $39.81 Median $60.26 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $39.81 | $60.26 | $74.13 |
Oscar Health Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $218.78 | Professional | None | $69.18 | $69.18 | $218.78 |
UPMC Health Plan Setting Facility Modifier None Typical Low $61.66 Median $190.55 Typical High $416.87 | Facility | None | $61.66 | $190.55 | $416.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $61.66 Median $97.72 Typical High $109.65 | Professional | None | $61.66 | $97.72 | $109.65 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $154.88 | Professional | None | $60.26 | $97.72 | $154.88 |
11 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 $28.18 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $28.18 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $11.48 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $64.57 Typical High $79.43 | Professional | 54 · Surgery only | $42.66 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $8.51 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.71 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.75 | $8.71 | $10.47 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service Typical Low $104.71 Median $112.20 Typical High $117.49 | Professional | 59 · Distinct service | $104.71 | $112.20 | $117.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $28.18 | $43.65 | $52.48 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $11.48 | $17.38 | $20.89 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $64.57 Typical High $79.43 | Professional | 54 · Surgery only | $42.66 | $64.57 | $79.43 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $8.51 | $12.88 | $15.85 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.71 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.75 | $8.71 | $10.47 |
Where Pennsylvania sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 45th of 51
$100
AK $309KY $79.43
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.