How much rates vary
Facilitymedian $2,951 · 10th to 90th $832 to $8,318Professionalmedian $741 · 10th to 90th $661 to $1,023
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 $831.76 Median $5,754.40 Typical High $10,471.29 | Facility | None | $831.76 | $5,754.40 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $758.58 | Professional | None | $660.69 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $537.03 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $56,234.13 | Professional | None | $1,096.48 | $1,174.90 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $5,011.87 | Facility | None | $954.99 | $2,884.03 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,584.89 | Professional | None | $676.08 | $741.31 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,148.15 | Professional | None | $870.96 | $1,148.15 | $1,148.15 |
Geisinger Setting Facility Modifier None Typical Low $2,951.21 Median $3,630.78 Typical High $6,456.54 | Facility | None | $2,951.21 | $3,630.78 | $6,456.54 |
Geisinger Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,513.56 | Professional | None | $676.08 | $870.96 | $1,513.56 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $5,370.32 Typical High $10,964.78 | Facility | None | $1,023.29 | $5,370.32 | $10,964.78 |
Martin's Point Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $758.58 | Professional | None | $660.69 | $724.44 | $758.58 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,380.38 | Professional | None | $851.14 | $851.14 | $1,380.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $691.83 Median $3,981.07 Typical High $7,943.28 | Facility | None | $691.83 | $3,981.07 | $7,943.28 |
UPMC Health Plan Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | None | $691.83 | $691.83 | $724.44 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $6,025.60 | Facility | None | $812.83 | $1,318.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,202.26 | Professional | None | $676.08 | $812.83 | $1,202.26 |
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 $331.13 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $75.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $354.81 | $380.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $141.25 | $154.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $537.03 | $575.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $114.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $75.86 |
Where Pennsylvania sits
The same service costs 8.5 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· 42nd of 51
$759
AK $3,020TX $355
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.