How much rates vary
Facilitymedian $3,631 · 10th to 90th $708 to $7,943Professionalmedian $759 · 10th to 90th $646 to $1,288
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 $758.58 Median $3,890.45 Typical High $8,317.64 | Facility | None | $758.58 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $758.58 | Professional | None | $645.65 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $489.78 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $489.78 | $524.81 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $1,380.38 | Professional | None | $724.44 | $758.58 | $1,380.38 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $5,888.44 | Facility | None | $501.19 | $2,691.53 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,584.89 | Professional | None | $676.08 | $741.31 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,174.90 | Professional | None | $870.96 | $1,174.90 | $1,174.90 |
Geisinger Setting Facility Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $7,943.28 | Facility | None | $3,630.78 | $4,466.84 | $7,943.28 |
Geisinger Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,513.56 | Professional | None | $676.08 | $891.25 | $1,513.56 |
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 $645.65 Median $707.95 Typical High $758.58 | Professional | None | $645.65 | $707.95 | $758.58 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $489.78 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $489.78 | $524.81 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $1,412.54 | Professional | None | $831.76 | $851.14 | $1,412.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $3,467.37 | Facility | None | $707.95 | $1,737.80 | $3,467.37 |
UPMC Health Plan Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $812.83 | Professional | None | $707.95 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,000.00 | Facility | None | $1,698.24 | $3,235.94 | $10,000.00 |
United Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,174.90 | Professional | None | $676.08 | $776.25 | $1,174.90 |
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 $323.59 Median $354.81 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $141.25 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $524.81 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $104.71 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $70.79 | $75.86 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,122.02 Typical High $2,041.74 | Professional | 50 · Both sides | $1,096.48 | $1,122.02 | $2,041.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $346.74 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $346.74 | $371.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $141.25 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $141.25 | $151.36 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $524.81 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $524.81 | $562.34 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $104.71 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $104.71 | $112.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $70.79 | $75.86 |
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· 44th of 51
$759
AK $2,951TX $380
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.