How much rates vary
Facilitymedian $3,890 · 10th to 90th $912 to $8,710Professionalmedian $933 · 10th to 90th $813 to $1,622
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 $933.25 Median $5,495.41 Typical High $8,709.64 | Facility | None | $933.25 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $933.25 | Professional | None | $812.83 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $660.69 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $1,698.24 | Professional | None | $912.01 | $933.25 | $1,698.24 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,801.89 Typical High $8,317.64 | Facility | None | $707.95 | $3,801.89 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,949.84 | Professional | None | $851.14 | $912.01 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,445.44 | $1,445.44 |
Geisinger Setting Facility Modifier None Typical Low $5,011.87 Median $6,309.57 Typical High $10,964.78 | Facility | None | $5,011.87 | $6,309.57 | $10,964.78 |
Geisinger Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,905.46 | Professional | None | $851.14 | $1,122.02 | $1,905.46 |
Martin's Point Setting Facility Modifier None Typical Low $933.25 Median $5,248.07 Typical High $8,709.64 | Facility | None | $933.25 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $933.25 | Professional | None | $812.83 | $891.25 | $933.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $660.69 |
Oscar Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,096.48 | $1,778.28 |
UPMC Health Plan Setting Facility Modifier None Typical Low $891.25 Median $2,570.40 Typical High $5,011.87 | Facility | None | $891.25 | $2,570.40 | $5,011.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,174.90 | Professional | None | $891.25 | $1,174.90 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,479.11 | Professional | None | $851.14 | $977.24 | $1,479.11 |
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 $407.38 Median $446.68 Typical High $467.74 | Professional | 52 · Reduced service | $407.38 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $616.60 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $93.33 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,412.54 Typical High $2,570.40 | Professional | 50 · Both sides | $1,348.96 | $1,412.54 | $2,570.40 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $407.38 | $436.52 | $467.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $173.78 | $186.21 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $616.60 | $660.69 | $707.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $141.25 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $93.33 |
Where Pennsylvania sits
The same service costs 7.9 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
$933
AK $3,715TX $468
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.