How much rates vary
Facilitymedian $3,715 · 10th to 90th $724 to $8,318Professionalmedian $1,698 · 10th to 90th $1,479 to $2,344
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 $1,479.11 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,479.11 | $1,621.81 | $1,698.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,122.02 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,122.02 | $1,174.90 |
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 $2,398.83 Median $2,630.27 Typical High $56,234.13 | Professional | None | $2,398.83 | $2,630.27 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,174.90 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,174.90 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $6,165.95 | Facility | None | $501.19 | $2,691.53 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $3,630.78 | Professional | None | $1,513.56 | $1,659.59 | $3,630.78 |
Emblem Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,819.70 | $2,398.83 | $2,398.83 |
Geisinger Setting Facility Modifier None Typical Low $3,715.35 Median $4,677.35 Typical High $8,128.31 | Facility | None | $3,715.35 | $4,677.35 | $8,128.31 |
Geisinger Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $3,467.37 | Professional | None | $1,445.44 | $1,905.46 | $3,467.37 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $1,698.24 | Professional | None | $1,479.11 | $1,584.89 | $1,698.24 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,122.02 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,122.02 | $1,174.90 |
Oscar Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,862.09 | $1,862.09 | $3,311.31 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,621.81 | $1,905.46 | $1,905.46 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,905.46 | $1,905.46 |
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 $1,513.56 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,778.28 | $2,691.53 |
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 $741.31 Median $812.83 Typical High $851.14 | Professional | 52 · Reduced service | $741.31 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $323.59 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,202.26 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,202.26 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $223.87 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $162.18 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $162.18 | $169.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $794.33 Typical High $851.14 | Professional | 52 · Reduced service | $741.31 | $794.33 | $851.14 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $316.23 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $316.23 | $338.84 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,202.26 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,202.26 | $1,258.93 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $223.87 | $239.88 | $257.04 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $158.49 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $158.49 | $169.82 |
Where Pennsylvania sits
The same service costs 20.4 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· 42nd of 51
$1,698
AK $6,607TX $324
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.