How much rates vary
Facilitymedian $2,884 · 10th to 90th $708 to $8,318Professionalmedian $2,399 · 10th to 90th $2,089 to $4,074
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 $2,089.30 Median $2,238.72 Typical High $2,398.83 | Professional | None | $2,089.30 | $2,238.72 | $2,398.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,584.89 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,584.89 | $1,659.59 |
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 $2,290.87 Median $2,398.83 Typical High $4,466.84 | Professional | None | $2,290.87 | $2,398.83 | $4,466.84 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,621.81 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,621.81 | $3,090.30 |
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 $2,137.96 Median $2,290.87 Typical High $5,011.87 | Professional | None | $2,137.96 | $2,290.87 | $5,011.87 |
Emblem Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,570.40 | $3,467.37 | $3,467.37 |
Geisinger Setting Professional Modifier None Typical Low $2,041.74 Median $2,691.53 Typical High $4,786.30 | Professional | None | $2,041.74 | $2,691.53 | $4,786.30 |
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 $2,089.30 Median $2,238.72 Typical High $2,398.83 | Professional | None | $2,089.30 | $2,238.72 | $2,398.83 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,548.82 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,548.82 | $1,659.59 |
Oscar Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $4,466.84 | Professional | None | $2,630.27 | $2,754.23 | $4,466.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,238.72 | $2,454.71 | $2,454.71 |
UPMC Health Plan Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,238.72 | $2,454.71 | $2,454.71 |
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 $2,089.30 Median $2,570.40 Typical High $3,801.89 | Professional | None | $2,089.30 | $2,570.40 | $3,801.89 |
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 $1,047.13 Median $1,122.02 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,047.13 | $1,122.02 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $446.68 Typical High $478.63 | Professional | 53 · Discontinued | $416.87 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,698.24 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,548.82 | $1,698.24 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $338.84 Typical High $354.81 | Professional | 55 · Aftercare only | $309.03 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $223.87 Typical High $239.88 | Professional | 56 · Pre-op care only | $208.93 | $223.87 | $239.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,096.48 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,047.13 | $1,096.48 | $1,174.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $446.68 Typical High $478.63 | Professional | 53 · Discontinued | $416.87 | $446.68 | $478.63 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,659.59 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,548.82 | $1,659.59 | $1,778.28 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $331.13 Typical High $354.81 | Professional | 55 · Aftercare only | $309.03 | $331.13 | $354.81 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $223.87 Typical High $239.88 | Professional | 56 · Pre-op care only | $208.93 | $223.87 | $239.88 |
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· 39th of 51
$2,399
AK $9,333TX $427
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.