How much rates vary
Facilitymedian $331 · 10th to 90th $100 to $3,020Professionalmedian $275 · 10th to 90th $234 to $447
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 $288.40 Median $2,137.96 Typical High $8,317.64 | Facility | None | $288.40 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $323.59 | Professional | None | $234.42 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $177.83 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $165.96 | $177.83 | $199.53 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $501.19 | Professional | None | $281.84 | $288.40 | $501.19 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $199.53 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $194.98 | $199.53 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $323.59 Typical High $575.44 | Facility | None | $144.54 | $323.59 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $478.63 | Professional | None | $223.87 | $269.15 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $537.03 | Professional | None | $398.11 | $537.03 | $537.03 |
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 $234.42 Median $346.74 Typical High $562.34 | Professional | None | $234.42 | $346.74 | $562.34 |
Highmark BCBS Setting Facility Modifier None Typical Low $218.78 Median $616.60 Typical High $1,348.96 | Facility | None | $218.78 | $616.60 | $1,348.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $239.88 Median $302.00 Typical High $354.81 | Professional | None | $239.88 | $302.00 | $354.81 |
Martin's Point Setting Facility Modifier None Typical Low $316.23 Median $2,137.96 Typical High $7,244.36 | Facility | None | $316.23 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $302.00 | Professional | None | $234.42 | $257.04 | $302.00 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $177.83 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $165.96 | $177.83 | $199.53 |
Oscar Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $501.19 | Professional | None | $331.13 | $331.13 | $501.19 |
UPMC Health Plan Setting Facility Modifier None Typical Low $218.78 Median $812.83 Typical High $1,862.09 | Facility | None | $218.78 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $281.84 | Professional | None | $218.78 | $269.15 | $281.84 |
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 $229.09 Median $281.84 Typical High $426.58 | Professional | None | $229.09 | $281.84 | $426.58 |
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 $117.49 Median $128.82 Typical High $144.54 | Professional | 52 · Reduced service | $117.49 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $57.54 | Professional | 53 · Discontinued | $46.77 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $190.55 Typical High $213.80 | Professional | 54 · Surgery only | $177.83 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $42.66 | Professional | 55 · Aftercare only | $35.48 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.70 Typical High $28.84 | Professional | 56 · Pre-op care only | $23.44 | $25.70 | $28.84 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $436.52 Typical High $758.58 | Professional | 50 · Both sides | $416.87 | $436.52 | $758.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $125.89 Typical High $144.54 | Professional | 52 · Reduced service | $117.49 | $125.89 | $144.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $46.77 | $50.12 | $57.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $190.55 Typical High $213.80 | Professional | 54 · Surgery only | $177.83 | $190.55 | $213.80 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.02 Typical High $42.66 | Professional | 55 · Aftercare only | $35.48 | $38.02 | $42.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $23.44 | $25.12 | $28.84 |
Where Pennsylvania sits
The same service costs 5.9 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· 40th of 51
$275
AK $1,096TX $186
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.