How much rates vary
Facilitymedian $3,715 · 10th to 90th $891 to $8,318Professionalmedian $2,754 · 10th to 90th $2,399 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 $1,023.29 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $2,951.21 | Professional | None | $2,570.40 | $2,630.27 | $2,951.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,862.09 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,862.09 | $2,041.74 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $10,715.19 Typical High $12,022.64 | Facility | None | $3,981.07 | $10,715.19 | $12,022.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $4,168.69 Median $4,466.84 Typical High $56,234.13 | Professional | None | $4,168.69 | $4,466.84 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,041.74 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,041.74 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,311.31 Typical High $5,888.44 | Facility | None | $602.56 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $5,888.44 | Professional | None | $2,398.83 | $2,691.53 | $5,888.44 |
Emblem Health Setting Professional Modifier None Typical Low $3,235.94 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,235.94 | $4,365.16 | $4,365.16 |
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 $2,511.89 Median $3,311.31 Typical High $5,623.41 | Professional | None | $2,511.89 | $3,311.31 | $5,623.41 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $4,786.30 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,786.30 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $2,951.21 | Professional | None | $2,570.40 | $2,630.27 | $2,951.21 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,862.09 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,862.09 | $2,041.74 |
Oscar Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $5,128.61 | Professional | None | $3,235.94 | $3,235.94 | $5,128.61 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $4,265.80 | Facility | None | $1,548.82 | $2,884.03 | $4,265.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $2,754.23 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,754.23 | $3,467.37 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,000.00 | Facility | None | $1,698.24 | $3,235.94 | $10,000.00 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $4,677.35 | Professional | None | $2,511.89 | $3,019.95 | $4,677.35 |
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 $1,288.25 Median $1,318.26 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,288.25 | $1,318.26 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $524.81 Typical High $588.84 | Professional | 53 · Discontinued | $512.86 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,995.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,905.46 | $1,995.26 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $398.11 Typical High $436.52 | Professional | 55 · Aftercare only | $380.19 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $263.03 Typical High $295.12 | Professional | 56 · Pre-op care only | $257.04 | $263.03 | $295.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,288.25 Median $1,318.26 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,288.25 | $1,318.26 | $1,479.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $524.81 Typical High $588.84 | Professional | 53 · Discontinued | $512.86 | $524.81 | $588.84 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,995.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,905.46 | $1,995.26 | $2,187.76 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $398.11 Typical High $436.52 | Professional | 55 · Aftercare only | $380.19 | $398.11 | $436.52 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $263.03 Typical High $295.12 | Professional | 56 · Pre-op care only | $257.04 | $263.03 | $295.12 |
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· 41st of 51
$2,818
AK $11,482TX $589
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.