How much rates vary
Facilitymedian $3,631 · 10th to 90th $676 to $8,710Professionalmedian $2,399 · 10th to 90th $2,188 to $3,388
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 $5,495.41 Typical High $8,709.64 | Facility | None | $1,047.13 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $2,570.40 | Professional | None | $2,187.76 | $2,398.83 | $2,570.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,659.59 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,659.59 | $1,778.28 |
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 $3,548.13 Median $3,890.45 Typical High $56,234.13 | Professional | None | $3,548.13 | $3,890.45 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,778.28 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,778.28 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $5,888.44 | Facility | None | $501.19 | $2,691.53 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $5,128.61 | Professional | None | $2,238.72 | $2,454.71 | $5,128.61 |
Emblem Health Setting Professional Modifier None Typical Low $2,884.03 Median $4,073.80 Typical High $4,073.80 | Professional | None | $2,884.03 | $4,073.80 | $4,073.80 |
Geisinger Setting Professional Modifier None Typical Low $2,238.72 Median $2,951.21 Typical High $5,011.87 | Professional | None | $2,238.72 | $2,951.21 | $5,011.87 |
Martin's Point Setting Facility Modifier None Typical Low $1,148.15 Median $5,248.07 Typical High $8,709.64 | Facility | None | $1,148.15 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $2,570.40 | Professional | None | $2,187.76 | $2,398.83 | $2,570.40 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,621.81 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,621.81 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,677.35 | Professional | None | $2,137.96 | $2,137.96 | $4,677.35 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Facility | None | $1,995.26 | $1,995.26 | $2,398.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,995.26 | $1,995.26 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,000.00 | Facility | None | $1,698.24 | $3,235.94 | $10,000.00 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $4,073.80 | Professional | None | $2,238.72 | $2,691.53 | $4,073.80 |
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 $1,096.48 Median $1,202.26 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,096.48 | $1,202.26 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $478.63 Typical High $512.86 | Professional | 53 · Discontinued | $436.52 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,778.28 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,659.59 | $1,778.28 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $363.08 Typical High $380.19 | Professional | 55 · Aftercare only | $331.13 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $239.88 Typical High $257.04 | Professional | 56 · Pre-op care only | $218.78 | $239.88 | $257.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,096.48 Median $1,148.15 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,096.48 | $1,148.15 | $1,288.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $457.09 Typical High $512.86 | Professional | 53 · Discontinued | $436.52 | $457.09 | $512.86 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,737.80 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,659.59 | $1,737.80 | $1,905.46 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $346.74 Typical High $380.19 | Professional | 55 · Aftercare only | $331.13 | $346.74 | $380.19 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $229.09 Typical High $257.04 | Professional | 56 · Pre-op care only | $218.78 | $229.09 | $257.04 |
Where Pennsylvania sits
The same service costs 4.0 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.
Physician feeFacility fee
AK $19,772TX $4,915
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.