How much rates vary
Facilitymedian $2,884 · 10th to 90th $708 to $8,318Professionalmedian $794 · 10th to 90th $692 to $1,349
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 $5,495.41 Typical High $8,709.64 | Facility | None | $831.76 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $794.33 | Professional | None | $691.83 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $562.34 |
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 $758.58 Median $794.33 Typical High $1,412.54 | Professional | None | $758.58 | $794.33 | $1,412.54 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,818.38 Typical High $4,897.79 | Facility | None | $549.54 | $2,818.38 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,659.59 | Professional | None | $707.95 | $741.31 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,202.26 | Professional | None | $912.01 | $1,202.26 | $1,202.26 |
Geisinger Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,584.89 | Professional | None | $707.95 | $912.01 | $1,584.89 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $8,709.64 | Facility | None | $912.01 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $794.33 | Professional | None | $691.83 | $741.31 | $794.33 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $512.86 | $562.34 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,445.44 | Professional | None | $831.76 | $831.76 | $1,445.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $707.95 Median $2,630.27 Typical High $4,365.16 | Facility | None | $707.95 | $2,630.27 | $4,365.16 |
UPMC Health Plan Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $741.31 | Professional | None | $707.95 | $707.95 | $741.31 |
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 $691.83 Median $851.14 Typical High $1,258.93 | Professional | None | $691.83 | $851.14 | $1,258.93 |
11 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 $346.74 Median $371.54 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $158.49 | Professional | 53 · Discontinued | $138.04 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $512.86 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $79.43 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,174.90 Typical High $2,089.30 | Professional | 50 · Both sides | $1,148.15 | $1,174.90 | $2,089.30 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $371.54 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $371.54 | $398.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $158.49 | Professional | 53 · Discontinued | $138.04 | $147.91 | $158.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $512.86 | $549.54 | $602.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $120.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $79.43 |
Where Pennsylvania sits
The same service costs 16.6 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· 40th of 51
$794
AK $3,090TX $186
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.