How much rates vary
Facilitymedian $2,884 · 10th to 90th $776 to $7,586Professionalmedian $501 · 10th to 90th $437 to $741
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 $436.52 Median $478.63 Typical High $501.19 | Professional | None | $436.52 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $331.13 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $302.00 | $331.13 | $346.74 |
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 $691.83 Median $691.83 Typical High $776.25 | Professional | None | $691.83 | $691.83 | $776.25 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $776.25 |
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 $467.74 Median $512.86 Typical High $1,122.02 | Professional | None | $467.74 | $512.86 | $1,122.02 |
Emblem Health Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $758.58 | Professional | None | $588.84 | $758.58 | $758.58 |
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 $457.09 Median $602.56 Typical High $1,096.48 | Professional | None | $457.09 | $602.56 | $1,096.48 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $4,897.79 Typical High $8,709.64 | Facility | None | $912.01 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $501.19 | Professional | None | $436.52 | $478.63 | $501.19 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $331.13 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $302.00 | $331.13 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $1,096.48 | Professional | None | $562.34 | $588.84 | $1,096.48 |
UPMC Health Plan Setting Facility Modifier None Typical Low $478.63 Median $2,570.40 Typical High $5,011.87 | Facility | None | $478.63 | $2,570.40 | $5,011.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $616.60 | Professional | None | $478.63 | $616.60 | $616.60 |
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 $467.74 Median $549.54 Typical High $831.76 | Professional | None | $467.74 | $549.54 | $831.76 |
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 $218.78 Median $239.88 Typical High $251.19 | Professional | 52 · Reduced service | $218.78 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $95.50 Typical High $100.00 | Professional | 53 · Discontinued | $87.10 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $47.86 Typical High $50.12 | Professional | 56 · Pre-op care only | $43.65 | $47.86 | $50.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $234.42 Typical High $251.19 | Professional | 52 · Reduced service | $218.78 | $234.42 | $251.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $100.00 | Professional | 53 · Discontinued | $87.10 | $93.33 | $100.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $354.81 | $371.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $74.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $50.12 |
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· 45th of 51
$513
AK $1,995TX $110
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.