How much rates vary
Facilitymedian $3,388 · 10th to 90th $676 to $14,791Professionalmedian $977 · 10th to 90th $832 to $1,585
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 $831.76 Median $4,897.79 Typical High $8,511.38 | Facility | None | $831.76 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $977.24 | Professional | None | $831.76 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $602.56 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $602.56 | $676.08 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $22,387.21 Typical High $28,183.83 | Facility | None | $3,981.07 | $22,387.21 | $28,183.83 |
Capital Blue Cross Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,659.59 | Professional | None | $933.25 | $977.24 | $1,659.59 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $8,709.64 Typical High $15,488.17 | Facility | None | $549.54 | $8,709.64 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,949.84 | Professional | None | $741.31 | $891.25 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,479.11 | $1,479.11 |
Geisinger Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,819.70 | Professional | None | $812.83 | $1,071.52 | $1,819.70 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $8,709.64 | Facility | None | $831.76 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $977.24 | Professional | None | $831.76 | $870.96 | $977.24 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $602.56 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $602.56 | $676.08 |
Oscar Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,148.15 | $1,659.59 |
UPMC Health Plan Setting Facility Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,047.13 | Facility | None | $912.01 | $1,047.13 | $1,047.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,047.13 | Professional | None | $912.01 | $1,047.13 | $1,047.13 |
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 $812.83 Median $1,000.00 Typical High $1,513.56 | Professional | None | $812.83 | $1,000.00 | $1,513.56 |
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 $416.87 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $416.87 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $645.65 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $97.72 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,445.44 Typical High $2,454.71 | Professional | 50 · Both sides | $1,412.54 | $1,445.44 | $2,454.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $416.87 | $436.52 | $489.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $173.78 | $194.98 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $645.65 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $645.65 | $724.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $144.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $97.72 |
Where Pennsylvania sits
The same service costs 16.2 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· 41st of 51
$977
AK $3,802TX $234
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.