How much rates vary
Facilitymedian $3,467 · 10th to 90th $813 to $7,943Professionalmedian $708 · 10th to 90th $617 to $1,230
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 $831.76 Median $5,495.41 Typical High $8,709.64 | Facility | None | $831.76 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | None | $616.60 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $501.19 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $1,288.25 | Professional | None | $691.83 | $707.95 | $1,288.25 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $489.78 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $478.63 | $489.78 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,388.44 Typical High $5,888.44 | Facility | None | $707.95 | $3,388.44 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,479.11 | Professional | None | $630.96 | $691.83 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
Geisinger Setting Facility Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $7,943.28 | Facility | None | $3,630.78 | $4,466.84 | $7,943.28 |
Geisinger Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,412.54 | Professional | None | $630.96 | $831.76 | $1,412.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $14,454.40 Median $14,454.40 Typical High $14,454.40 | Facility | None | $14,454.40 | $14,454.40 | $14,454.40 |
Highmark BCBS Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $4,897.79 Typical High $8,709.64 | Facility | None | $912.01 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | None | $616.60 | $660.69 | $707.95 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,318.26 | Professional | None | $794.33 | $851.14 | $1,318.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $660.69 Median $2,570.40 Typical High $5,011.87 | Facility | None | $660.69 | $2,570.40 | $5,011.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | None | $660.69 | $707.95 | $707.95 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,096.48 | Professional | None | $630.96 | $741.31 | $1,096.48 |
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 $309.03 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $141.25 | Professional | 53 · Discontinued | $123.03 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $70.79 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,071.52 Typical High $1,949.84 | Professional | 50 · Both sides | $1,023.29 | $1,071.52 | $1,949.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $331.13 | $354.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $123.03 | $131.83 | $141.25 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $501.19 | $537.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $107.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $70.79 |
Where Pennsylvania sits
The same service costs 7.8 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· 44th of 51
$708
AK $2,818TX $363
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.