How much rates vary
Facilitymedian $1,514 · 10th to 90th $550 to $4,677Professionalmedian $2,138 · 10th to 90th $1,698 to $3,548
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 $1,621.81 Median $1,778.28 Typical High $2,137.96 | Facility | None | $1,621.81 | $1,778.28 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,905.46 | $2,137.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $954.99 Typical High $1,071.52 | Professional | 52 · Reduced service | $776.25 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $380.19 Typical High $426.58 | Professional | 53 · Discontinued | $316.23 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $281.84 Typical High $323.59 | Professional | 55 · Aftercare only | $234.42 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $190.55 Typical High $213.80 | Professional | 56 · Pre-op care only | $158.49 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,318.26 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,318.26 | $1,513.56 |
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 $2,137.96 Median $2,238.72 Typical High $4,786.30 | Professional | None | $2,137.96 | $2,238.72 | $4,786.30 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $1,995.26 | Facility | None | $501.19 | $977.24 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,187.76 | $3,630.78 |
Emblem Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,818.38 | $3,715.35 | $3,715.35 |
Geisinger Setting Facility Modifier None Typical Low $954.99 Median $1,174.90 Typical High $2,089.30 | Facility | None | $954.99 | $1,174.90 | $2,089.30 |
Geisinger Setting Professional Modifier None Typical Low $2,089.30 Median $2,818.38 Typical High $6,760.83 | Professional | None | $2,089.30 | $2,818.38 | $6,760.83 |
Martin's Point Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,137.96 | Facility | None | $1,778.28 | $1,778.28 | $2,137.96 |
Martin's Point Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,905.46 | $2,137.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $954.99 Typical High $1,071.52 | Professional | 52 · Reduced service | $776.25 | $954.99 | $1,071.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $380.19 Typical High $426.58 | Professional | 53 · Discontinued | $316.23 | $380.19 | $426.58 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $281.84 Typical High $323.59 | Professional | 55 · Aftercare only | $234.42 | $281.84 | $323.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $190.55 Typical High $213.80 | Professional | 56 · Pre-op care only | $158.49 | $190.55 | $213.80 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,318.26 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,318.26 | $1,513.56 |
Oscar Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $4,677.35 | Professional | None | $2,454.71 | $2,884.03 | $4,677.35 |
UPMC Health Plan Setting Facility Modifier None Typical Low $223.87 Median $524.81 Typical High $3,235.94 | Facility | None | $223.87 | $524.81 | $3,235.94 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,698.24 | $2,041.74 | $3,235.94 |
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 $1,819.70 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,819.70 | $2,238.72 | $3,467.37 |
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 50 · Both sides Typical Low $3,235.94 Median $3,311.31 Typical High $7,244.36 | Professional | 50 · Both sides | $3,235.94 | $3,311.31 | $7,244.36 |
Where Pennsylvania sits
The same service costs 5.5 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· 40th of 51
$2,138
AK $6,918TX $1,259
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.