How much rates vary
Facilitymedian $1,660 · 10th to 90th $447 to $5,129Professionalmedian $437 · 10th to 90th $380 to $759
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 $537.03 Median $2,344.23 Typical High $8,317.64 | Facility | None | $537.03 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $436.52 | Professional | None | $380.19 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $309.03 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $794.33 | Professional | None | $426.58 | $446.68 | $794.33 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $309.03 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $295.12 | $309.03 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,513.56 Typical High $2,630.27 | Facility | None | $338.84 | $1,513.56 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $933.25 | Professional | None | $371.54 | $426.58 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $707.95 | Professional | None | $524.81 | $707.95 | $707.95 |
Geisinger Setting Facility Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,467.37 | Facility | None | $1,584.89 | $1,995.26 | $3,467.37 |
Geisinger Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $870.96 | Professional | None | $389.05 | $512.86 | $870.96 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $7,244.36 | Facility | None | $588.84 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $436.52 | Professional | None | $380.19 | $407.38 | $436.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $309.03 |
Oscar Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $794.33 | Professional | None | $478.63 | $478.63 | $794.33 |
UPMC Health Plan Setting Facility Modifier None Typical Low $407.38 Median $1,122.02 Typical High $2,238.72 | Facility | None | $407.38 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | None | $407.38 | $407.38 | $416.87 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,466.84 | Facility | None | $812.83 | $1,318.26 | $4,466.84 |
United Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $676.08 | Professional | None | $380.19 | $457.09 | $676.08 |
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 $190.55 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $40.74 | $43.65 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $660.69 Typical High $1,174.90 | Professional | 50 · Both sides | $645.65 | $660.69 | $1,174.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $204.17 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $81.28 | $89.13 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $309.03 | $331.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $66.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $40.74 | $43.65 |
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· 43rd of 51
$437
AK $1,738TX $209
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.