How much rates vary
Facilitymedian $372 · 10th to 90th $100 to $2,818Professionalmedian $380 · 10th to 90th $316 to $646
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 $407.38 Median $1,995.26 Typical High $7,943.28 | Facility | None | $407.38 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $457.09 | Professional | None | $316.23 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $251.19 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $223.87 | $251.19 | $281.84 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $707.95 | Professional | None | $398.11 | $407.38 | $707.95 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $323.59 Typical High $562.34 | Facility | None | $144.54 | $323.59 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $660.69 | Professional | None | $302.00 | $371.54 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $758.58 | Professional | None | $562.34 | $758.58 | $758.58 |
Geisinger Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $288.40 | Facility | None | $131.83 | $165.96 | $288.40 |
Geisinger Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $794.33 | Professional | None | $338.84 | $489.78 | $794.33 |
Highmark BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,148.15 Typical High $1,318.26 | Facility | None | $512.86 | $1,148.15 | $1,318.26 |
Highmark BCBS Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $501.19 | Professional | None | $363.08 | $436.52 | $501.19 |
Martin's Point Setting Facility Modifier None Typical Low $407.38 Median $1,995.26 Typical High $6,606.93 | Facility | None | $407.38 | $1,995.26 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $426.58 | Professional | None | $316.23 | $363.08 | $426.58 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $251.19 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $223.87 | $251.19 | $281.84 |
Oscar Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $707.95 | Professional | None | $407.38 | $407.38 | $707.95 |
UPMC Health Plan Setting Facility Modifier None Typical Low $309.03 Median $812.83 Typical High $1,862.09 | Facility | None | $309.03 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $380.19 | Professional | None | $309.03 | $354.81 | $380.19 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $602.56 | Professional | None | $316.23 | $398.11 | $602.56 |
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 $158.49 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $158.49 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $63.10 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $269.15 Typical High $302.00 | Professional | 54 · Surgery only | $239.88 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $53.70 Typical High $60.26 | Professional | 55 · Aftercare only | $47.86 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $35.48 Typical High $40.74 | Professional | 56 · Pre-op care only | $31.62 | $35.48 | $40.74 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $616.60 Typical High $1,071.52 | Professional | 50 · Both sides | $588.84 | $616.60 | $1,071.52 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $158.49 | $177.83 | $204.17 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $63.10 | $70.79 | $81.28 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $269.15 Typical High $302.00 | Professional | 54 · Surgery only | $239.88 | $269.15 | $302.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $53.70 Typical High $60.26 | Professional | 55 · Aftercare only | $47.86 | $53.70 | $60.26 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $35.48 Typical High $40.74 | Professional | 56 · Pre-op care only | $31.62 | $35.48 | $40.74 |
Where Pennsylvania sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 40th of 51
$380
AK $1,479UT $288
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.