How much rates vary
Facilitymedian $5,623 · 10th to 90th $794 to $30,903Professionalmedian $1,585 · 10th to 90th $1,380 to $2,951
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 $1,288.25 Median $5,128.61 Typical High $9,332.54 | Facility | None | $1,288.25 | $5,128.61 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,513.56 | $1,819.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
AmeriHealth Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,659.59 | $1,659.59 | $1,905.46 |
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 $1,513.56 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,513.56 | $1,584.89 | $3,090.30 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,096.48 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,096.48 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $19,498.45 Typical High $36,307.81 | Facility | None | $549.54 | $19,498.45 | $36,307.81 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $3,311.31 | Professional | None | $1,412.54 | $1,548.82 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,511.89 Typical High $2,951.21 | Professional | None | $1,819.70 | $2,511.89 | $2,951.21 |
Geisinger Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,380.38 | $1,862.09 | $3,162.28 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $38,018.94 Typical High $66,069.34 | Facility | None | $4,073.80 | $38,018.94 | $66,069.34 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,513.56 | $1,995.26 | $3,311.31 |
Independence Blue Cross Setting Professional Modifier None Typical Low $831.76 Median $1,659.59 Typical High $1,819.70 | Professional | None | $831.76 | $1,659.59 | $1,819.70 |
Martin's Point Setting Facility Modifier None Typical Low $1,288.25 Median $4,466.84 Typical High $9,772.37 | Facility | None | $1,288.25 | $4,466.84 | $9,772.37 |
Martin's Point Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,513.56 | $1,659.59 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,023.29 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $954.99 | $1,023.29 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $2,951.21 | Professional | None | $1,737.80 | $1,819.70 | $2,951.21 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,479.11 Median $4,570.88 Typical High $7,244.36 | Facility | None | $1,479.11 | $4,570.88 | $7,244.36 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,778.28 | $1,778.28 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $23,988.33 | Facility | None | $2,818.38 | $5,495.41 | $23,988.33 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,698.24 | $2,511.89 |
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 $691.83 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $724.44 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $724.44 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $288.40 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $288.40 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,096.48 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,023.29 | $1,096.48 | $1,202.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $218.78 Typical High $239.88 | Professional | 55 · Aftercare only | $204.17 | $218.78 | $239.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $144.54 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $144.54 | $158.49 |
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 62 · Two surgeons | $1,698.24 | $1,698.24 | $1,698.24 |
Where Pennsylvania sits
The same service costs 10.6 times more in Alaska than in Kentucky. 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 $37,069KY $3,499
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.