How much rates vary
Facilitymedian $2,818 · 10th to 90th $692 to $7,413Professionalmedian $661 · 10th to 90th $562 to $1,122
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 $812.83 Median $4,897.79 Typical High $8,511.38 | Facility | None | $812.83 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $660.69 | Professional | None | $562.34 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $457.09 |
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 $630.96 Median $660.69 Typical High $1,174.90 | Professional | None | $630.96 | $660.69 | $1,174.90 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $457.09 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $436.52 | $457.09 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,311.31 Typical High $5,888.44 | Facility | None | $616.60 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $1,380.38 | Professional | None | $588.84 | $630.96 | $1,380.38 |
Emblem Health Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,023.29 | Professional | None | $758.58 | $1,023.29 | $1,023.29 |
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 $588.84 Median $776.25 Typical High $1,318.26 | Professional | None | $588.84 | $776.25 | $1,318.26 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $4,570.88 Typical High $8,511.38 | Facility | None | $831.76 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $660.69 | Professional | None | $562.34 | $616.60 | $660.69 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $457.09 |
Oscar Health Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $1,230.27 | Professional | None | $741.31 | $758.58 | $1,230.27 |
UPMC Health Plan Setting Facility Modifier None Typical Low $616.60 Median $2,137.96 Typical High $4,168.69 | Facility | None | $616.60 | $2,137.96 | $4,168.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | None | $616.60 | $676.08 | $676.08 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $6,025.60 | Facility | None | $812.83 | $1,318.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,023.29 | Professional | None | $588.84 | $676.08 | $1,023.29 |
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 $281.84 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $281.84 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $112.20 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $489.78 | Professional | 54 · Surgery only | $426.58 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $97.72 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $66.07 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $977.24 Typical High $1,778.28 | Professional | 50 · Both sides | $954.99 | $977.24 | $1,778.28 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $281.84 | $309.03 | $331.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $112.20 | $123.03 | $131.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $489.78 | Professional | 54 · Surgery only | $426.58 | $457.09 | $489.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $97.72 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $97.72 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $66.07 |
Where Pennsylvania sits
The same service costs 8.3 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· 41st of 51
$661
AK $2,570TX $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.