How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $8,318Professionalmedian $2,239 · 10th to 90th $1,950 to $3,090
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 $1,949.84 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,949.84 | $2,137.96 | $2,238.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,479.11 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,479.11 | $1,548.82 |
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 $3,162.28 Median $3,388.44 Typical High $56,234.13 | Professional | None | $3,162.28 | $3,388.44 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $2,884.03 |
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 $1,995.26 Median $2,290.87 Typical High $4,786.30 | Professional | None | $1,995.26 | $2,290.87 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,398.83 | $3,162.28 | $3,162.28 |
Geisinger Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $4,897.79 | Professional | None | $1,905.46 | $2,570.40 | $4,897.79 |
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 $1,949.84 Median $2,089.30 Typical High $2,238.72 | Professional | None | $1,949.84 | $2,089.30 | $2,238.72 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,445.44 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,445.44 | $1,548.82 |
Oscar Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,630.27 Typical High $4,677.35 | Professional | None | $2,454.71 | $2,630.27 | $4,677.35 |
UPMC Health Plan Setting Facility Modifier None Typical Low $2,137.96 Median $3,090.30 Typical High $3,090.30 | Facility | None | $2,137.96 | $3,090.30 | $3,090.30 |
UPMC Health Plan Setting Professional Modifier None Typical Low $2,137.96 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,137.96 | $3,090.30 | $3,090.30 |
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 $2,041.74 Median $2,398.83 Typical High $3,548.13 | Professional | None | $2,041.74 | $2,398.83 | $3,548.13 |
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 $977.24 Median $1,071.52 Typical High $1,122.02 | Professional | 52 · Reduced service | $977.24 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $426.58 Typical High $446.68 | Professional | 53 · Discontinued | $389.05 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,584.89 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,445.44 | $1,584.89 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $316.23 Typical High $331.13 | Professional | 55 · Aftercare only | $295.12 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $213.80 Typical High $223.87 | Professional | 56 · Pre-op care only | $194.98 | $213.80 | $223.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $1,047.13 Typical High $1,122.02 | Professional | 52 · Reduced service | $977.24 | $1,047.13 | $1,122.02 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $416.87 Typical High $446.68 | Professional | 53 · Discontinued | $389.05 | $416.87 | $446.68 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,548.82 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,445.44 | $1,548.82 | $1,659.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $316.23 Typical High $331.13 | Professional | 55 · Aftercare only | $295.12 | $316.23 | $331.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $223.87 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $223.87 |
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· 42nd of 51
$2,239
AK $8,710TX $398
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.