How much rates vary
Facilitymedian $3,631 · 10th to 90th $741 to $7,943Professionalmedian $295 · 10th to 90th $251 to $617
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 $588.84 Median $4,073.80 Typical High $8,511.38 | Facility | None | $588.84 | $4,073.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $346.74 | Professional | None | $251.19 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $134.90 Typical High $141.25 | Professional | 52 · Reduced service | $125.89 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $53.70 Typical High $57.54 | Professional | 53 · Discontinued | $50.12 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $204.17 Typical High $213.80 | Professional | 54 · Surgery only | $186.21 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $40.74 Typical High $42.66 | Professional | 55 · Aftercare only | $37.15 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.92 Typical High $28.18 | Professional | 56 · Pre-op care only | $25.12 | $26.92 | $28.18 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $239.88 | Professional | None | $190.55 | $190.55 | $239.88 |
AmeriHealth Setting Facility Modifier None Typical Low $3,630.78 Median $4,570.88 Typical High $25,118.86 | Facility | None | $3,630.78 | $4,570.88 | $25,118.86 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $56,234.13 | Professional | None | $407.38 | $436.52 | $56,234.13 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,311.31 Typical High $5,888.44 | Facility | None | $616.60 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $812.83 | Professional | None | $263.03 | $371.54 | $812.83 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $416.87 | Professional | None | $309.03 | $416.87 | $416.87 |
Geisinger Setting Facility Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $7,943.28 | Facility | None | $3,630.78 | $4,466.84 | $7,943.28 |
Geisinger Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $870.96 | Professional | None | $245.47 | $371.54 | $870.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $741.31 Median $4,570.88 Typical High $22,908.68 | Facility | None | $741.31 | $4,570.88 | $22,908.68 |
Highmark BCBS Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $316.23 | Professional | None | $229.09 | $288.40 | $316.23 |
Independence Blue Cross Setting Facility Modifier None Typical Low $3,090.30 Median $4,570.88 Typical High $25,118.86 | Facility | None | $3,090.30 | $4,570.88 | $25,118.86 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $4,073.80 Typical High $8,511.38 | Facility | None | $588.84 | $4,073.80 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $331.13 | Professional | None | $251.19 | $269.15 | $331.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $131.83 Typical High $141.25 | Professional | 52 · Reduced service | $125.89 | $131.83 | $141.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $57.54 | Professional | 53 · Discontinued | $50.12 | $52.48 | $57.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $199.53 Typical High $213.80 | Professional | 54 · Surgery only | $186.21 | $199.53 | $213.80 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $39.81 Typical High $42.66 | Professional | 55 · Aftercare only | $37.15 | $39.81 | $42.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $28.18 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $28.18 |
Oscar Health Setting Professional Modifier None Typical Low $363.08 Median $707.95 Typical High $758.58 | Professional | None | $363.08 | $707.95 | $758.58 |
UPMC Health Plan Setting Facility Modifier None Typical Low $269.15 Median $2,137.96 Typical High $4,168.69 | Facility | None | $269.15 | $2,137.96 | $4,168.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $269.15 Median $616.60 Typical High $616.60 | Professional | None | $269.15 | $616.60 | $616.60 |
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 $263.03 Median $338.84 Typical High $588.84 | Professional | None | $263.03 | $338.84 | $588.84 |
1 more rate 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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $426.58 |
Where Pennsylvania sits
The same service costs 13.6 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $11,880MT $873
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.