How much rates vary
Facilitymedian $2,188 · 10th to 90th $676 to $6,310Professionalmedian $2,138 · 10th to 90th $1,905 to $3,802
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 $1,862.09 Median $1,995.26 Typical High $2,137.96 | Professional | None | $1,862.09 | $1,995.26 | $2,137.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,412.54 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,412.54 | $1,479.11 |
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 $2,041.74 Median $2,137.96 Typical High $3,890.45 | Professional | None | $2,041.74 | $2,137.96 | $3,890.45 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,479.11 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,479.11 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,122.02 Typical High $2,238.72 | Facility | None | $549.54 | $1,122.02 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $4,466.84 | Professional | None | $1,995.26 | $2,290.87 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,344.23 | $3,162.28 | $3,162.28 |
Geisinger Setting Professional Modifier None Typical Low $1,862.09 Median $2,691.53 Typical High $5,248.07 | Professional | None | $1,862.09 | $2,691.53 | $5,248.07 |
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 $1,862.09 Median $1,995.26 Typical High $2,137.96 | Professional | None | $1,862.09 | $1,995.26 | $2,137.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,380.38 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,380.38 | $1,479.11 |
Oscar Health Setting Professional Modifier None Typical Low $2,344.23 Median $3,090.30 Typical High $4,466.84 | Professional | None | $2,344.23 | $3,090.30 | $4,466.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,995.26 Median $2,951.21 Typical High $2,951.21 | Facility | None | $1,995.26 | $2,951.21 | $2,951.21 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,995.26 Median $2,951.21 Typical High $2,951.21 | Professional | None | $1,995.26 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $6,165.95 | Facility | None | $1,698.24 | $3,162.28 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,949.84 | $2,290.87 | $3,467.37 |
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 $933.25 Median $1,000.00 Typical High $1,071.52 | Professional | 52 · Reduced service | $933.25 | $1,000.00 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $398.11 Typical High $426.58 | Professional | 53 · Discontinued | $371.54 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,513.56 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,380.38 | $1,513.56 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $302.00 Typical High $316.23 | Professional | 55 · Aftercare only | $275.42 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $199.53 Typical High $213.80 | Professional | 56 · Pre-op care only | $186.21 | $199.53 | $213.80 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $3,162.28 Typical High $5,888.44 | Professional | 50 · Both sides | $3,090.30 | $3,162.28 | $5,888.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,000.00 Typical High $1,071.52 | Professional | 52 · Reduced service | $933.25 | $1,000.00 | $1,071.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $398.11 Typical High $426.58 | Professional | 53 · Discontinued | $371.54 | $398.11 | $426.58 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,479.11 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,380.38 | $1,479.11 | $1,584.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $302.00 Typical High $316.23 | Professional | 55 · Aftercare only | $275.42 | $302.00 | $316.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $199.53 Typical High $213.80 | Professional | 56 · Pre-op care only | $186.21 | $199.53 | $213.80 |
Where Pennsylvania sits
The same service costs 19.5 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· 44th of 51
$2,138
AK $8,318TX $427
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.