How much rates vary
Facilitymedian $3,388 · 10th to 90th $676 to $10,965Professionalmedian $759 · 10th to 90th $661 to $1,318
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 $724.44 Median $4,897.79 Typical High $8,511.38 | Facility | None | $724.44 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $758.58 | Professional | None | $660.69 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $537.03 |
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 $741.31 Median $776.25 Typical High $1,380.38 | Professional | None | $741.31 | $776.25 | $1,380.38 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $6,309.57 Typical High $10,964.78 | Facility | None | $549.54 | $6,309.57 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,584.89 | Professional | None | $660.69 | $741.31 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | None | $870.96 | $1,202.26 | $1,202.26 |
Geisinger Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,479.11 | Professional | None | $660.69 | $870.96 | $1,479.11 |
Martin's Point Setting Facility Modifier None Typical Low $758.58 Median $3,801.89 Typical High $8,709.64 | Facility | None | $758.58 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | None | $660.69 | $707.95 | $758.58 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,412.54 | Professional | None | $851.14 | $954.99 | $1,412.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $724.44 Median $870.96 Typical High $870.96 | Facility | None | $724.44 | $870.96 | $870.96 |
UPMC Health Plan Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $870.96 | Professional | None | $724.44 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,715.19 | Facility | None | $1,698.24 | $3,235.94 | $10,715.19 |
United Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,202.26 | Professional | None | $676.08 | $794.33 | $1,202.26 |
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 $331.13 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $131.83 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $75.86 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,148.15 Typical High $2,089.30 | Professional | 50 · Both sides | $1,122.02 | $1,148.15 | $2,089.30 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $354.81 | $380.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $151.36 | Professional | 53 · Discontinued | $131.83 | $141.25 | $151.36 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $537.03 | $575.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $114.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $75.86 |
Where Pennsylvania sits
The same service costs 8.3 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
$759
AK $3,020TX $363
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.