How much rates vary
Facilitymedian $380 · 10th to 90th $100 to $3,020Professionalmedian $389 · 10th to 90th $316 to $646
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 $416.87 Median $2,137.96 Typical High $8,317.64 | Facility | None | $416.87 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $416.87 | Professional | None | $331.13 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $295.12 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $56,234.13 | Facility | None | $2,630.27 | $3,019.95 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $707.95 | Professional | None | $407.38 | $426.58 | $707.95 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $295.12 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $281.84 | $295.12 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $323.59 Typical High $562.34 | Facility | None | $144.54 | $323.59 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $676.08 | Professional | None | $288.40 | $371.54 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $776.25 | Professional | None | $575.44 | $776.25 | $776.25 |
Geisinger Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $288.40 | Facility | None | $131.83 | $165.96 | $288.40 |
Geisinger Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $776.25 | Professional | None | $316.23 | $501.19 | $776.25 |
Highmark BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $331.13 Median $371.54 Typical High $416.87 | Professional | None | $331.13 | $371.54 | $416.87 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $645.65 | Professional | None | $380.19 | $380.19 | $645.65 |
UPMC Health Plan Setting Facility Modifier None Typical Low $288.40 Median $812.83 Typical High $1,862.09 | Facility | None | $288.40 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $389.05 | Professional | None | $288.40 | $389.05 | $389.05 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $616.60 | Professional | None | $302.00 | $407.38 | $616.60 |
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 $165.96 Median $186.21 Typical High $208.93 | Professional | 52 · Reduced service | $165.96 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $275.42 Typical High $316.23 | Professional | 54 · Surgery only | $245.47 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $41.69 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $630.96 Typical High $1,071.52 | Professional | 50 · Both sides | $616.60 | $630.96 | $1,071.52 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $186.21 Typical High $208.93 | Professional | 52 · Reduced service | $165.96 | $186.21 | $208.93 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $74.13 | $83.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $275.42 Typical High $316.23 | Professional | 54 · Surgery only | $245.47 | $275.42 | $316.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $63.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $41.69 |
Where Pennsylvania sits
The same service costs 5.2 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· 38th of 51
$389
AK $1,514TX $288
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.