How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $8,318Professionalmedian $2,884 · 10th to 90th $2,512 to $3,981
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 $2,511.89 Median $2,691.53 Typical High $2,884.03 | Professional | None | $2,511.89 | $2,691.53 | $2,884.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,862.09 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,862.09 | $2,041.74 |
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 $4,168.69 Median $4,466.84 Typical High $56,234.13 | Professional | None | $4,168.69 | $4,466.84 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $1,995.26 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $1,905.46 | $1,995.26 | $4,168.69 |
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 $2,570.40 Median $2,818.38 Typical High $6,165.95 | Professional | None | $2,570.40 | $2,818.38 | $6,165.95 |
Emblem Health Setting Professional Modifier None Typical Low $3,090.30 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,090.30 | $4,073.80 | $4,073.80 |
Geisinger Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $6,025.60 | Professional | None | $2,454.71 | $3,235.94 | $6,025.60 |
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 $2,511.89 Median $2,691.53 Typical High $2,884.03 | Professional | None | $2,511.89 | $2,691.53 | $2,884.03 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,862.09 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,862.09 | $2,041.74 |
Oscar Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,467.37 Typical High $5,623.41 | Professional | None | $3,162.28 | $3,467.37 | $5,623.41 |
UPMC Health Plan Setting Facility Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $3,162.28 | Facility | None | $2,754.23 | $3,162.28 | $3,162.28 |
UPMC Health Plan Setting Professional Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,754.23 | $3,162.28 | $3,162.28 |
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 $2,630.27 Median $3,090.30 Typical High $4,570.88 | Professional | None | $2,630.27 | $3,090.30 | $4,570.88 |
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 $1,258.93 Median $1,348.96 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,258.93 | $1,348.96 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $537.03 Typical High $575.44 | Professional | 53 · Discontinued | $501.19 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,995.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,905.46 | $1,995.26 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $407.38 Typical High $436.52 | Professional | 55 · Aftercare only | $380.19 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $269.15 Typical High $288.40 | Professional | 56 · Pre-op care only | $251.19 | $269.15 | $288.40 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,258.93 Median $1,348.96 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,258.93 | $1,348.96 | $1,445.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $537.03 Typical High $575.44 | Professional | 53 · Discontinued | $501.19 | $537.03 | $575.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,995.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,905.46 | $1,995.26 | $2,187.76 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $407.38 Typical High $436.52 | Professional | 55 · Aftercare only | $380.19 | $407.38 | $436.52 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $269.15 Typical High $288.40 | Professional | 56 · Pre-op care only | $251.19 | $269.15 | $288.40 |
Where Pennsylvania sits
The same service costs 20.9 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· 41st of 51
$2,884
AK $11,220TX $537
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.