How much rates vary
Facilitymedian $3,020 · 10th to 90th $741 to $8,710Professionalmedian $1,023 · 10th to 90th $912 to $1,778
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 $1,047.13 Median $5,754.40 Typical High $10,471.29 | Facility | None | $1,047.13 | $5,754.40 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,047.13 | Professional | None | $912.01 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $724.44 |
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 $1,000.00 Median $1,047.13 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,047.13 | $1,905.46 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $724.44 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $691.83 | $724.44 | $1,318.26 |
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 $891.25 Median $1,000.00 Typical High $2,187.76 | Professional | None | $891.25 | $1,000.00 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,548.82 | $1,548.82 |
Geisinger Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,995.26 | Professional | None | $870.96 | $1,148.15 | $1,995.26 |
Martin's Point Setting Facility Modifier None Typical Low $1,047.13 Median $5,370.32 Typical High $10,964.78 | Facility | None | $1,047.13 | $5,370.32 | $10,964.78 |
Martin's Point Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,047.13 | Professional | None | $912.01 | $977.24 | $1,047.13 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $724.44 |
Oscar Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,047.13 | $1,905.46 |
UPMC Health Plan Setting Facility Modifier None Typical Low $912.01 Median $3,467.37 Typical High $5,888.44 | Facility | None | $912.01 | $3,467.37 | $5,888.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $977.24 | Professional | None | $912.01 | $912.01 | $977.24 |
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 $912.01 Median $1,122.02 Typical High $1,659.59 | Professional | None | $912.01 | $1,122.02 | $1,659.59 |
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 $457.09 Median $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $457.09 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $181.97 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $776.25 | Professional | 54 · Surgery only | $676.08 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $104.71 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,548.82 Typical High $2,884.03 | Professional | 50 · Both sides | $1,513.56 | $1,548.82 | $2,884.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $457.09 | $489.78 | $524.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $181.97 | $194.98 | $208.93 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $776.25 | Professional | 54 · Surgery only | $676.08 | $724.44 | $776.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $158.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $104.71 |
Where Pennsylvania sits
The same service costs 18.2 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· 40th of 51
$1,047
AK $4,074TX $224
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.