How much rates vary
Facilitymedian $5,495 · 10th to 90th $692 to $14,125Professionalmedian $2,239 · 10th to 90th $1,950 to $3,802
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 $1,071.52 Median $5,495.41 Typical High $9,332.54 | Facility | None | $1,071.52 | $5,495.41 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,238.72 | Professional | None | $1,949.84 | $2,089.30 | $2,238.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,479.11 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,479.11 | $1,548.82 |
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 $2,137.96 Median $2,238.72 Typical High $4,168.69 | Professional | None | $2,137.96 | $2,238.72 | $4,168.69 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,698.24 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,698.24 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $8,511.38 Typical High $15,135.61 | Facility | None | $549.54 | $8,511.38 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,137.96 Typical High $4,677.35 | Professional | None | $2,041.74 | $2,137.96 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,454.71 | $3,311.31 | $3,311.31 |
Geisinger Setting Professional Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $4,677.35 | Professional | None | $1,949.84 | $2,570.40 | $4,677.35 |
Martin's Point Setting Facility Modifier None Typical Low $1,071.52 Median $5,128.61 Typical High $9,772.37 | Facility | None | $1,071.52 | $5,128.61 | $9,772.37 |
Martin's Point Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,238.72 | Professional | None | $1,949.84 | $2,089.30 | $2,238.72 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,445.44 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,445.44 | $1,548.82 |
Oscar Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,630.27 Typical High $4,466.84 | Professional | None | $2,454.71 | $2,630.27 | $4,466.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,089.30 | $2,630.27 | $2,630.27 |
UPMC Health Plan Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,630.27 | $2,630.27 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $14,454.40 | Facility | None | $2,818.38 | $5,495.41 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,398.83 | $3,548.13 |
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 $977.24 Median $1,047.13 Typical High $1,122.02 | Professional | 52 · Reduced service | $977.24 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $416.87 Typical High $446.68 | Professional | 53 · Discontinued | $389.05 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,584.89 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,445.44 | $1,584.89 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $331.13 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $223.87 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $223.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $1,047.13 Typical High $1,122.02 | Professional | 52 · Reduced service | $977.24 | $1,047.13 | $1,122.02 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $416.87 Typical High $446.68 | Professional | 53 · Discontinued | $389.05 | $416.87 | $446.68 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,548.82 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,445.44 | $1,548.82 | $1,659.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $309.03 Typical High $331.13 | Professional | 55 · Aftercare only | $288.40 | $309.03 | $331.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $223.87 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $223.87 |
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 62 · Two surgeons | $2,089.30 | $2,089.30 | $2,089.30 |
Where Pennsylvania sits
The same service costs 6.5 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· 43rd of 51
$2,239
AK $8,710TX $1,349
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.