How much rates vary
Facilitymedian $5,012 · 10th to 90th $676 to $21,878Professionalmedian $3,388 · 10th to 90th $2,951 to $5,754
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 $831.76 Median $4,897.79 Typical High $8,511.38 | Facility | None | $831.76 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $3,019.95 Typical High $3,388.44 | Professional | None | $2,951.21 | $3,019.95 | $3,388.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,187.76 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,187.76 | $2,344.23 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $3,235.94 Median $3,388.44 Typical High $6,309.57 | Professional | None | $3,235.94 | $3,388.44 | $6,309.57 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,344.23 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,344.23 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $12,882.50 Typical High $22,387.21 | Facility | None | $549.54 | $12,882.50 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $7,079.46 | Professional | None | $2,951.21 | $3,235.94 | $7,079.46 |
Emblem Health Setting Professional Modifier None Typical Low $3,715.35 Median $5,011.87 Typical High $5,011.87 | Professional | None | $3,715.35 | $5,011.87 | $5,011.87 |
Geisinger Setting Professional Modifier None Typical Low $2,951.21 Median $3,890.45 Typical High $7,079.46 | Professional | None | $2,951.21 | $3,890.45 | $7,079.46 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $8,709.64 | Facility | None | $831.76 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $2,951.21 Median $3,019.95 Typical High $3,388.44 | Professional | None | $2,951.21 | $3,019.95 | $3,388.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,137.96 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,137.96 | $2,344.23 |
Oscar Health Setting Professional Modifier None Typical Low $3,715.35 Median $4,677.35 Typical High $5,888.44 | Professional | None | $3,715.35 | $4,677.35 | $5,888.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $3,162.28 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,162.28 | $3,311.31 | $3,311.31 |
UPMC Health Plan Setting Professional Modifier None Typical Low $3,162.28 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,162.28 | $3,311.31 | $3,311.31 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $15,848.93 | Facility | None | $2,818.38 | $5,495.41 | $15,848.93 |
United Setting Professional Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $5,370.32 | Professional | None | $2,884.03 | $3,630.78 | $5,370.32 |
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 $1,479.11 Median $1,548.82 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,479.11 | $1,548.82 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $616.60 Typical High $676.08 | Professional | 53 · Discontinued | $588.84 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,344.23 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,187.76 | $2,344.23 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $467.74 Typical High $501.19 | Professional | 55 · Aftercare only | $436.52 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $309.03 Typical High $338.84 | Professional | 56 · Pre-op care only | $295.12 | $309.03 | $338.84 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $4,897.79 Median $5,011.87 Typical High $9,549.93 | Professional | 50 · Both sides | $4,897.79 | $5,011.87 | $9,549.93 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,479.11 Median $1,513.56 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,479.11 | $1,513.56 | $1,698.24 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $602.56 Typical High $676.08 | Professional | 53 · Discontinued | $588.84 | $602.56 | $676.08 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,290.87 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,187.76 | $2,290.87 | $2,511.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $457.09 Typical High $501.19 | Professional | 55 · Aftercare only | $436.52 | $457.09 | $501.19 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $302.00 Typical High $338.84 | Professional | 56 · Pre-op care only | $295.12 | $302.00 | $338.84 |
Where Pennsylvania sits
The same service costs 20.4 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· 41st of 51
$3,388
AK $13,183TX $646
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.