How much rates vary
Facilitymedian $3,981 · 10th to 90th $646 to $8,511Professionalmedian $603 · 10th to 90th $525 to $1,023
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 $676.08 Median $3,890.45 Typical High $8,317.64 | Facility | None | $676.08 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | None | $524.81 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $426.58 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $1,071.52 | Professional | None | $588.84 | $602.56 | $1,071.52 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $7,585.78 | Facility | None | $501.19 | $2,691.53 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $1,258.93 | Professional | None | $524.81 | $562.34 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $954.99 | Professional | None | $707.95 | $954.99 | $954.99 |
Geisinger Setting Facility Modifier None Typical Low $4,570.88 Median $5,623.41 Typical High $10,000.00 | Facility | None | $4,570.88 | $5,623.41 | $10,000.00 |
Geisinger Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,174.90 | Professional | None | $524.81 | $691.83 | $1,174.90 |
Highmark BCBS Setting Facility Modifier None Typical Low $53,703.18 Median $53,703.18 Typical High $53,703.18 | Facility | None | $53,703.18 | $53,703.18 | $53,703.18 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $602.56 | Professional | None | $524.81 | $549.54 | $602.56 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $426.58 |
Oscar Health Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,071.52 | Professional | None | $676.08 | $741.31 | $1,071.52 |
UPMC Health Plan Setting Facility Modifier None Typical Low $562.34 Median $1,737.80 Typical High $3,388.44 | Facility | None | $562.34 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | None | $562.34 | $616.60 | $616.60 |
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 $512.86 Median $630.96 Typical High $933.25 | Professional | None | $512.86 | $630.96 | $933.25 |
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 $263.03 Median $281.84 Typical High $302.00 | Professional | 52 · Reduced service | $263.03 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $120.23 | Professional | 53 · Discontinued | $104.71 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $60.26 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $60.26 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $912.01 Typical High $1,621.81 | Professional | 50 · Both sides | $870.96 | $912.01 | $1,621.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $263.03 | $275.42 | $302.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $104.71 | $109.65 | $120.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $407.38 | $457.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $91.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $60.26 |
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· 43rd of 51
$603
AK $2,399TX $309
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.