How much rates vary
Facilitymedian $2,570 · 10th to 90th $676 to $7,762Professionalmedian $1,202 · 10th to 90th $1,096 to $1,660
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 $954.99 Median $3,235.94 Typical High $8,511.38 | Facility | None | $954.99 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,174.90 | $1,258.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $831.76 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $831.76 | $870.96 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $56,234.13 | Professional | None | $1,698.24 | $1,819.70 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,691.53 Typical High $4,897.79 | Facility | None | $524.81 | $2,691.53 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,174.90 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,737.80 | $1,737.80 |
Geisinger Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,380.38 | $2,511.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $16,218.10 Median $16,218.10 Typical High $16,218.10 | Facility | None | $16,218.10 | $16,218.10 | $16,218.10 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $8,317.64 | Facility | None | $954.99 | $2,818.38 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,148.15 | $1,258.93 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $870.96 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,288.25 | $2,454.71 | $2,454.71 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,174.90 | Facility | None | $1,023.29 | $1,122.02 | $1,174.90 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,174.90 | Professional | None | $1,023.29 | $1,122.02 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,318.26 | $1,949.84 |
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 $549.54 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $549.54 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $251.19 | Professional | 53 · Discontinued | $218.78 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $125.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $562.34 Typical High $630.96 | Professional | 52 · Reduced service | $549.54 | $562.34 | $630.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $218.78 | $229.09 | $251.19 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $851.14 | $933.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $190.55 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $125.89 |
Where Pennsylvania sits
The same service costs 16.6 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· 40th of 51
$1,230
AK $4,677TX $282
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.