How much rates vary
Facilitymedian $1,995 · 10th to 90th $646 to $5,495Professionalmedian $646 · 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 $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 $562.34 Median $616.60 Typical High $645.65 | Professional | None | $562.34 | $616.60 | $645.65 |
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 $501.19 Median $1,584.89 Typical High $2,691.53 | Facility | None | $501.19 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $1,348.96 | Professional | None | $549.54 | $630.96 | $1,348.96 |
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 $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 $575.44 Median $741.31 Typical High $1,258.93 | Professional | None | $575.44 | $741.31 | $1,258.93 |
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 $562.34 Median $602.56 Typical High $645.65 | Professional | None | $562.34 | $602.56 | $645.65 |
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 $676.08 Median $676.08 Typical High $1,174.90 | Professional | None | $676.08 | $676.08 | $1,174.90 |
UPMC Health Plan Setting Facility Modifier None Typical Low $588.84 Median $1,737.80 Typical High $3,388.44 | Facility | None | $588.84 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $616.60 | Professional | None | $588.84 | $588.84 | $616.60 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $5,888.44 | Facility | None | $1,148.15 | $1,905.46 | $5,888.44 |
United Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,023.29 | Professional | None | $562.34 | $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 $302.00 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $302.00 | $323.59 |
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 $91.20 Typical High $97.72 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $64.57 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $977.24 Typical High $1,737.80 | Professional | 50 · Both sides | $954.99 | $977.24 | $1,737.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $302.00 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $302.00 | $323.59 |
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 $60.26 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $64.57 |
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· 42nd of 51
$646
AK $2,570TX $331
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.