How much rates vary
Facilitymedian $3,020 · 10th to 90th $794 to $7,762Professionalmedian $741 · 10th to 90th $575 to $977
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 $758.58 Median $5,248.07 Typical High $8,709.64 | Facility | None | $758.58 | $5,248.07 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $851.14 | Professional | None | $549.54 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $363.08 Typical High $426.58 | Professional | 52 · Reduced service | $275.42 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $147.91 Typical High $169.82 | Professional | 53 · Discontinued | $109.65 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $549.54 Typical High $645.65 | Professional | 54 · Surgery only | $416.87 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $83.18 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $74.13 Typical High $85.11 | Professional | 56 · Pre-op care only | $54.95 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $512.86 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $389.05 | $512.86 | $602.56 |
AmeriHealth Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | None | $389.05 | $389.05 | $398.11 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $56,234.13 | Professional | None | $912.01 | $977.24 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $549.54 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $537.03 | $549.54 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,288.25 | Professional | None | $575.44 | $741.31 | $1,288.25 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,380.38 | $1,380.38 |
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 $645.65 Median $912.01 Typical High $1,659.59 | Professional | None | $645.65 | $912.01 | $1,659.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $16,982.44 Median $16,982.44 Typical High $19,952.62 | Facility | None | $16,982.44 | $16,982.44 | $19,952.62 |
Independence Blue Cross Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | None | $389.05 | $389.05 | $398.11 |
Martin's Point Setting Facility Modifier None Typical Low $851.14 Median $4,897.79 Typical High $8,709.64 | Facility | None | $851.14 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $851.14 | Professional | None | $549.54 | $741.31 | $851.14 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $363.08 Typical High $426.58 | Professional | 52 · Reduced service | $275.42 | $363.08 | $426.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $147.91 Typical High $169.82 | Professional | 53 · Discontinued | $109.65 | $147.91 | $169.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $549.54 Typical High $645.65 | Professional | 54 · Surgery only | $416.87 | $549.54 | $645.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $83.18 | $109.65 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $74.13 Typical High $85.11 | Professional | 56 · Pre-op care only | $54.95 | $74.13 | $85.11 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $512.86 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $389.05 | $512.86 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,621.81 | Professional | None | $676.08 | $676.08 | $1,621.81 |
UPMC Health Plan Setting Facility Modifier None Typical Low $660.69 Median $1,819.70 Typical High $4,265.80 | Facility | None | $660.69 | $1,819.70 | $4,265.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $831.76 | Professional | None | $602.56 | $794.33 | $831.76 |
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 $588.84 Median $776.25 Typical High $1,148.15 | Professional | None | $588.84 | $776.25 | $1,148.15 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | GC · Resident with teaching physician | $416.87 | $416.87 | $416.87 |
Where Pennsylvania sits
The same service costs 6.2 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· 43rd of 51
$741
AK $3,020TX $490
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.