How much rates vary
Facilitymedian $3,548 · 10th to 90th $741 to $7,586Professionalmedian $1,096 · 10th to 90th $955 to $1,862
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 $891.25 Median $3,890.45 Typical High $8,317.64 | Facility | None | $891.25 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,122.02 | Professional | None | $954.99 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $776.25 |
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 $1,071.52 Median $1,096.48 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,096.48 | $1,905.46 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $1,318.26 |
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 $933.25 Median $1,023.29 Typical High $2,290.87 | Professional | None | $933.25 | $1,023.29 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,737.80 | $1,737.80 |
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 $954.99 Median $1,258.93 Typical High $2,137.96 | Professional | None | $954.99 | $1,258.93 | $2,137.96 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $3,801.89 Typical High $8,317.64 | Facility | None | $954.99 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,122.02 | Professional | None | $954.99 | $1,023.29 | $1,122.02 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $776.25 |
Oscar Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,230.27 | $1,348.96 | $1,949.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $3,467.37 | Facility | None | $1,047.13 | $1,737.80 | $3,467.37 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,047.13 | $1,096.48 | $1,096.48 |
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 $933.25 Median $1,122.02 Typical High $1,659.59 | Professional | None | $933.25 | $1,122.02 | $1,659.59 |
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 $478.63 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $223.87 | Professional | 53 · Discontinued | $190.55 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $831.76 | Professional | 54 · Surgery only | $724.44 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $112.20 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,659.59 Typical High $2,818.38 | Professional | 50 · Both sides | $1,584.89 | $1,659.59 | $2,818.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $501.19 | $562.34 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $223.87 | Professional | 53 · Discontinued | $190.55 | $204.17 | $223.87 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $831.76 | Professional | 54 · Surgery only | $724.44 | $758.58 | $831.76 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $165.96 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $112.20 |
Where Pennsylvania sits
The same service costs 5.1 times more in Colorado than in Hawaii. 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
CO $14,362HI $2,794
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.