How much rates vary
Facilitymedian $1,950 · 10th to 90th $631 to $5,495Professionalmedian $661 · 10th to 90th $575 to $1,148
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 $660.69 Median $3,090.30 Typical High $8,511.38 | Facility | None | $660.69 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $660.69 | Professional | None | $575.44 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $467.74 |
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 $645.65 Median $660.69 Typical High $1,174.90 | Professional | None | $645.65 | $660.69 | $1,174.90 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,548.82 Typical High $2,630.27 | Facility | None | $478.63 | $1,548.82 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $1,380.38 | Professional | None | $602.56 | $645.65 | $1,380.38 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $776.25 | $1,047.13 | $1,047.13 |
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 $776.25 Typical High $1,348.96 | Professional | None | $575.44 | $776.25 | $1,348.96 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $8,317.64 | Facility | None | $724.44 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $660.69 | Professional | None | $575.44 | $602.56 | $660.69 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $467.74 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,174.90 | Professional | None | $707.95 | $707.95 | $1,174.90 |
UPMC Health Plan Setting Facility Modifier None Typical Low $616.60 Median $1,513.56 Typical High $2,951.21 | Facility | None | $616.60 | $1,513.56 | $2,951.21 |
UPMC Health Plan Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | None | $616.60 | $724.44 | $724.44 |
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 $691.83 Typical High $1,023.29 | Professional | None | $562.34 | $691.83 | $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 $288.40 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $426.58 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $100.00 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $57.54 | $61.66 | $66.07 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,000.00 Typical High $1,778.28 | Professional | 50 · Both sides | $954.99 | $1,000.00 | $1,778.28 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $302.00 | $331.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $120.23 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $120.23 | $131.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $501.19 | Professional | 54 · Surgery only | $426.58 | $457.09 | $501.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $100.00 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $100.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $57.54 | $60.26 | $66.07 |
Where Pennsylvania sits
The same service costs 18.6 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
$661
AK $2,630TX $141
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.