How much rates vary
Facilitymedian $3,715 · 10th to 90th $724 to $8,710Professionalmedian $1,549 · 10th to 90th $977 to $2,692
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 $1,348.96 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,348.96 | $1,445.44 | $1,548.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,096.48 |
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 $1,548.82 Typical High $2,884.03 | Professional | None | $1,513.56 | $1,548.82 | $2,884.03 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,388.44 Typical High $6,025.60 | Facility | None | $549.54 | $3,388.44 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,445.44 Typical High $3,162.28 | Professional | None | $831.76 | $1,445.44 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,737.80 | $2,344.23 | $2,344.23 |
Geisinger Setting Professional Modifier None Typical Low $891.25 Median $1,584.89 Typical High $2,344.23 | Professional | None | $891.25 | $1,584.89 | $2,344.23 |
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 $1,348.96 Median $1,412.54 Typical High $1,548.82 | Professional | None | $1,348.96 | $1,412.54 | $1,548.82 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $954.99 | $977.24 | $1,096.48 |
Oscar Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,174.90 | $1,737.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $977.24 Median $3,467.37 Typical High $5,495.41 | Facility | None | $977.24 | $3,467.37 | $5,495.41 |
UPMC Health Plan Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,479.11 | Professional | None | $977.24 | $977.24 | $1,479.11 |
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 $891.25 Median $1,621.81 Typical High $2,454.71 | Professional | None | $891.25 | $1,621.81 | $2,454.71 |
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 $676.08 Median $724.44 Typical High $776.25 | Professional | 52 · Reduced service | $676.08 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $288.40 Typical High $309.03 | Professional | 53 · Discontinued | $269.15 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $218.78 Typical High $234.42 | Professional | 55 · Aftercare only | $204.17 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $144.54 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $144.54 | $154.88 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,344.23 Typical High $4,365.16 | Professional | 50 · Both sides | $2,238.72 | $2,344.23 | $4,365.16 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $691.83 Typical High $776.25 | Professional | 52 · Reduced service | $676.08 | $691.83 | $776.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $309.03 | Professional | 53 · Discontinued | $269.15 | $281.84 | $309.03 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,023.29 | $1,047.13 | $1,174.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $204.17 | $208.93 | $234.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $154.88 |
Where Pennsylvania sits
The same service costs 5.5 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 $15,938KY $2,890
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.