How much rates vary
Facilitymedian $372 · 10th to 90th $63 to $4,074Professionalmedian $85 · 10th to 90th $59 to $129
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 $91.20 Median $2,344.23 Typical High $8,317.64 | Facility | None | $91.20 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $109.65 | Professional | None | $60.26 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $56.23 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $42.66 | $56.23 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
AmeriHealth Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | None | $45.71 | $45.71 | $48.98 |
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 $102.33 Median $102.33 Typical High $144.54 | Professional | None | $102.33 | $102.33 | $144.54 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $81.28 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $77.62 | $81.28 | $177.83 |
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 $58.88 Median $85.11 Typical High $138.04 | Professional | None | $58.88 | $85.11 | $138.04 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Geisinger Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $165.96 | Professional | None | $79.43 | $114.82 | $165.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | None | $91.20 | $91.20 | $102.33 |
Independence Blue Cross Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | None | $45.71 | $45.71 | $48.98 |
Martin's Point Setting Facility Modifier None Typical Low $426.58 Median $2,137.96 Typical High $7,244.36 | Facility | None | $426.58 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $107.15 | Professional | None | $60.26 | $87.10 | $107.15 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $56.23 Typical High $64.57 | Professional | 78 · Unplanned return to OR | $42.66 | $56.23 | $64.57 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $186.21 | Professional | None | $100.00 | $100.00 | $186.21 |
UPMC Health Plan Setting Facility Modifier None Typical Low $60.26 Median $199.53 Typical High $436.52 | Facility | None | $60.26 | $199.53 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $97.72 | Professional | None | $60.26 | $83.18 | $97.72 |
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 $63.10 Median $89.13 Typical High $151.36 | Professional | None | $63.10 | $89.13 | $151.36 |
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 $30.20 Median $39.81 Typical High $45.71 | Professional | 52 · Reduced service | $30.20 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.85 Typical High $18.20 | Professional | 53 · Discontinued | $12.02 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $60.26 Typical High $69.18 | Professional | 54 · Surgery only | $45.71 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.02 Typical High $13.80 | Professional | 55 · Aftercare only | $9.12 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.94 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.03 | $7.94 | $9.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $39.81 Typical High $45.71 | Professional | 52 · Reduced service | $30.20 | $39.81 | $45.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.85 Typical High $18.20 | Professional | 53 · Discontinued | $12.02 | $15.85 | $18.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $60.26 Typical High $69.18 | Professional | 54 · Surgery only | $45.71 | $60.26 | $69.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.02 Typical High $13.80 | Professional | 55 · Aftercare only | $9.12 | $12.02 | $13.80 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.94 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.03 | $7.94 | $9.12 |
Where Pennsylvania sits
The same service costs 3.8 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· 46th of 51
$87.10
AK $288KY $75.86
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.