How much rates vary
Facilitymedian $3,548 · 10th to 90th $832 to $8,318Professionalmedian $871 · 10th to 90th $759 to $1,479
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 $870.96 Median $4,897.79 Typical High $8,511.38 | Facility | None | $870.96 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | None | $758.58 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $602.56 |
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 $831.76 Median $870.96 Typical High $1,584.89 | Professional | None | $831.76 | $870.96 | $1,584.89 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,311.31 Typical High $5,888.44 | Facility | None | $616.60 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,819.70 | Professional | None | $758.58 | $851.14 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,348.96 | $1,348.96 |
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 $776.25 Median $1,023.29 Typical High $1,737.80 | Professional | None | $776.25 | $1,023.29 | $1,737.80 |
Martin's Point Setting Facility Modifier None Typical Low $870.96 Median $4,570.88 Typical High $8,511.38 | Facility | None | $870.96 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | None | $758.58 | $812.83 | $870.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,548.82 | Professional | None | $977.24 | $1,000.00 | $1,548.82 |
UPMC Health Plan Setting Facility Modifier None Typical Low $812.83 Median $2,137.96 Typical High $4,168.69 | Facility | None | $812.83 | $2,137.96 | $4,168.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $954.99 | Professional | None | $812.83 | $954.99 | $954.99 |
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 $758.58 Median $912.01 Typical High $1,348.96 | Professional | None | $758.58 | $912.01 | $1,348.96 |
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 $380.19 Median $407.38 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $131.83 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $87.10 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,318.26 Typical High $2,398.83 | Professional | 50 · Both sides | $1,258.93 | $1,318.26 | $2,398.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $407.38 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $407.38 | $436.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $162.18 | $173.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $602.56 | $645.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $131.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $87.10 |
Where Pennsylvania sits
The same service costs 7.6 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· 43rd of 51
$871
AK $3,388TX $447
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.