How much rates vary
Facilitymedian $3,802 · 10th to 90th $676 to $14,125Professionalmedian $1,514 · 10th to 90th $977 to $2,239
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 $1,000.00 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,000.00 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,122.02 | Professional | None | $977.24 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $741.31 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $676.08 | $741.31 | $794.33 |
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 $1,584.89 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,659.59 | $2,818.38 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $2,454.71 Typical High $4,265.80 | Professional | 50 · Both sides | $2,398.83 | $2,454.71 | $4,265.80 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,148.15 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,148.15 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $15,135.61 | Facility | None | $501.19 | $2,691.53 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $2,398.83 | Professional | None | $977.24 | $1,096.48 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,148.15 | $2,344.23 |
Geisinger Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,513.56 | $3,019.95 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $4,786.30 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,786.30 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,122.02 | Professional | None | $977.24 | $1,071.52 | $1,122.02 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $741.31 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $676.08 | $741.31 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,737.80 | $2,041.74 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,548.82 | $1,659.59 | $1,659.59 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,548.82 | $1,659.59 | $1,659.59 |
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 $1,023.29 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,621.81 | $2,398.83 |
10 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 $489.78 Median $524.81 Typical High $562.34 | Professional | 52 · Reduced service | $489.78 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $213.80 Typical High $223.87 | Professional | 53 · Discontinued | $194.98 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $724.44 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $158.49 Typical High $169.82 | Professional | 55 · Aftercare only | $147.91 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $107.15 Typical High $112.20 | Professional | 56 · Pre-op care only | $97.72 | $107.15 | $112.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $524.81 Typical High $562.34 | Professional | 52 · Reduced service | $489.78 | $524.81 | $562.34 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $213.80 Typical High $223.87 | Professional | 53 · Discontinued | $194.98 | $213.80 | $223.87 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $724.44 | $794.33 | $851.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $158.49 Typical High $169.82 | Professional | 55 · Aftercare only | $147.91 | $158.49 | $169.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $107.15 Typical High $112.20 | Professional | 56 · Pre-op care only | $97.72 | $107.15 | $112.20 |
Where Pennsylvania sits
The same service costs 46.8 times more in Alaska 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.
Pennsylvania· 26th of 51
$1,549
AK $4,467HI $95.50
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.