How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $8,318Professionalmedian $1,995 · 10th to 90th $1,738 to $3,020
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 $1,737.80 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,737.80 | $1,905.46 | $1,995.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,348.96 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,348.96 | $1,412.54 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $2,884.03 Median $3,090.30 Typical High $56,234.13 | Professional | None | $2,884.03 | $3,090.30 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,380.38 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,380.38 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,548.13 Typical High $6,165.95 | Facility | None | $549.54 | $3,548.13 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $4,466.84 | Professional | None | $1,778.28 | $1,949.84 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,187.76 | $2,818.38 | $2,818.38 |
Geisinger Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $4,265.80 | Professional | None | $1,698.24 | $2,290.87 | $4,265.80 |
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 $1,737.80 Median $1,862.09 Typical High $1,995.26 | Professional | None | $1,737.80 | $1,862.09 | $1,995.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,318.26 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,318.26 | $1,412.54 |
Oscar Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $4,073.80 | Professional | None | $2,238.72 | $2,398.83 | $4,073.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $3,019.95 | Facility | None | $1,905.46 | $3,019.95 | $3,019.95 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $3,019.95 | Professional | None | $1,905.46 | $3,019.95 | $3,019.95 |
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 $2,137.96 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,137.96 | $3,162.28 |
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 $870.96 Median $954.99 Typical High $1,000.00 | Professional | 52 · Reduced service | $870.96 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $380.19 Typical High $398.11 | Professional | 53 · Discontinued | $354.81 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,445.44 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,318.26 | $1,445.44 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $288.40 Typical High $302.00 | Professional | 55 · Aftercare only | $263.03 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $190.55 Typical High $199.53 | Professional | 56 · Pre-op care only | $173.78 | $190.55 | $199.53 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $933.25 Typical High $1,000.00 | Professional | 52 · Reduced service | $870.96 | $933.25 | $1,000.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $380.19 Typical High $398.11 | Professional | 53 · Discontinued | $354.81 | $380.19 | $398.11 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,412.54 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,318.26 | $1,412.54 | $1,513.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $281.84 Typical High $302.00 | Professional | 55 · Aftercare only | $263.03 | $281.84 | $302.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $186.21 Typical High $199.53 | Professional | 56 · Pre-op care only | $173.78 | $186.21 | $199.53 |
Where Pennsylvania sits
The same service costs 21.9 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· 44th of 51
$1,995
AK $7,943TX $363
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.