How much rates vary
Facilitymedian $427 · 10th to 90th $162 to $3,802Professionalmedian $209 · 10th to 90th $148 to $355
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 $239.88 Median $2,344.23 Typical High $8,317.64 | Facility | None | $239.88 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $239.88 | Professional | None | $144.54 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $100.00 | $141.25 | $165.96 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,630.27 Median $2,818.38 Typical High $8,709.64 | Facility | None | $2,630.27 | $2,818.38 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $407.38 | Professional | None | $218.78 | $229.09 | $407.38 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $181.97 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $177.83 | $181.97 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $316.23 Typical High $562.34 | Facility | None | $154.88 | $316.23 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $346.74 | Professional | None | $151.36 | $190.55 | $346.74 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $398.11 | Professional | None | $295.12 | $398.11 | $398.11 |
Geisinger Setting Facility Modifier None Typical Low $141.25 Median $177.83 Typical High $309.03 | Facility | None | $141.25 | $177.83 | $309.03 |
Geisinger Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $436.52 | Professional | None | $181.97 | $251.19 | $436.52 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $7,244.36 | Facility | None | $478.63 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $239.88 | Professional | None | $144.54 | $204.17 | $239.88 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $100.00 | $141.25 | $165.96 |
Oscar Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $416.87 | Professional | None | $199.53 | $199.53 | $416.87 |
UPMC Health Plan Setting Facility Modifier None Typical Low $144.54 Median $812.83 Typical High $1,862.09 | Facility | None | $144.54 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $218.78 | Professional | None | $144.54 | $181.97 | $218.78 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $3,467.37 | Facility | None | $199.53 | $436.52 | $3,467.37 |
United Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $309.03 | Professional | None | $162.18 | $204.17 | $309.03 |
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 $72.44 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $72.44 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $28.84 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $107.15 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.45 | $20.42 | $23.99 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $346.74 Typical High $616.60 | Professional | 50 · Both sides | $331.13 | $346.74 | $616.60 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $72.44 | $102.33 | $117.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $28.84 | $40.74 | $47.86 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $107.15 | $151.36 | $177.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $21.38 | $30.20 | $35.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.45 | $20.42 | $23.99 |
Where Pennsylvania sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 37th of 51
$214
AK $646FL $174
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.