How much rates vary
Facilitymedian $3,631 · 10th to 90th $676 to $8,710Professionalmedian $1,778 · 10th to 90th $1,479 to $3,090
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 $1,584.89 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,621.81 | $1,862.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,148.15 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,148.15 | $1,288.25 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $10,715.19 Typical High $12,022.64 | Facility | None | $3,981.07 | $10,715.19 | $12,022.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,778.28 | $1,862.09 | $3,162.28 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,258.93 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,258.93 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,951.21 Typical High $5,888.44 | Facility | None | $501.19 | $2,951.21 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $3,715.35 | Professional | None | $1,380.38 | $1,698.24 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,238.72 | $3,235.94 | $3,235.94 |
Geisinger Setting Professional Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,412.54 | $2,137.96 | $3,235.94 |
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 $1,584.89 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,621.81 | $1,862.09 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,148.15 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,148.15 | $1,288.25 |
Oscar Health Setting Professional Modifier None Typical Low $15.14 Median $1,698.24 Typical High $2,884.03 | Professional | None | $15.14 | $1,698.24 | $2,884.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Facility | None | $1,479.11 | $1,479.11 | $1,737.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,479.11 | $1,737.80 |
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 $1,445.44 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,862.09 | $2,818.38 |
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 $794.33 Median $812.83 Typical High $933.25 | Professional | 52 · Reduced service | $794.33 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $323.59 Typical High $371.54 | Professional | 53 · Discontinued | $316.23 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,230.27 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,174.90 | $1,230.27 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $275.42 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $162.18 Typical High $186.21 | Professional | 56 · Pre-op care only | $158.49 | $162.18 | $186.21 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $812.83 Typical High $933.25 | Professional | 52 · Reduced service | $794.33 | $812.83 | $933.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $323.59 Typical High $371.54 | Professional | 53 · Discontinued | $316.23 | $323.59 | $371.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,230.27 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,174.90 | $1,230.27 | $1,380.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $275.42 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $275.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $162.18 Typical High $186.21 | Professional | 56 · Pre-op care only | $158.49 | $162.18 | $186.21 |
Where Pennsylvania sits
The same service costs 11.2 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· 35th of 51
$1,862
AK $7,244TX $646
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.