How much rates vary
Facilitymedian $1,950 · 10th to 90th $631 to $5,370Professionalmedian $1,288 · 10th to 90th $603 to $2,239
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 $954.99 Median $3,090.30 Typical High $8,511.38 | Facility | None | $954.99 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,202.26 | $1,288.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $812.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $794.33 | $812.83 | $912.01 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $8,709.64 | Facility | None | $3,981.07 | $7,413.10 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,318.26 | $2,398.83 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $1,659.59 |
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 $575.44 Median $1,202.26 Typical High $2,630.27 | Professional | None | $575.44 | $1,202.26 | $2,630.27 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,995.26 | $1,995.26 |
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 $588.84 Median $1,288.25 Typical High $1,905.46 | Professional | None | $588.84 | $1,288.25 | $1,905.46 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $8,317.64 | Facility | None | $954.99 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,174.90 | $1,288.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $812.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $794.33 | $812.83 | $912.01 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,445.44 | Professional | None | $691.83 | $691.83 | $1,445.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $588.84 Median $1,513.56 Typical High $3,019.95 | Facility | None | $588.84 | $1,513.56 | $3,019.95 |
UPMC Health Plan Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,230.27 | Professional | None | $588.84 | $588.84 | $1,230.27 |
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 $602.56 Median $1,348.96 Typical High $2,041.74 | Professional | None | $602.56 | $1,348.96 | $2,041.74 |
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 $562.34 Median $575.44 Typical High $645.65 | Professional | 52 · Reduced service | $562.34 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $257.04 | Professional | 53 · Discontinued | $223.87 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $870.96 Typical High $977.24 | Professional | 54 · Surgery only | $851.14 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $173.78 Typical High $194.98 | Professional | 55 · Aftercare only | $169.82 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $128.82 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $1,949.84 Typical High $3,630.78 | Professional | 50 · Both sides | $1,905.46 | $1,949.84 | $3,630.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $575.44 Typical High $645.65 | Professional | 52 · Reduced service | $562.34 | $575.44 | $645.65 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $257.04 | Professional | 53 · Discontinued | $223.87 | $234.42 | $257.04 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $870.96 Typical High $977.24 | Professional | 54 · Surgery only | $851.14 | $870.96 | $977.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $173.78 Typical High $194.98 | Professional | 55 · Aftercare only | $169.82 | $173.78 | $194.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $128.82 |
Where Pennsylvania sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $9,494KY $2,537
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.