How much rates vary
Facilitymedian $1,288 · 10th to 90th $661 to $5,129Professionalmedian $631 · 10th to 90th $550 to $1,096
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 $676.08 Median $3,890.45 Typical High $8,317.64 | Facility | None | $676.08 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $616.60 | Professional | None | $537.03 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $436.52 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $1,122.02 | Professional | None | $602.56 | $630.96 | $1,122.02 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $891.25 Typical High $1,698.24 | Facility | None | $501.19 | $891.25 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $1,318.26 | Professional | None | $575.44 | $660.69 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,000.00 | Professional | None | $724.44 | $1,000.00 | $1,000.00 |
Geisinger Setting Facility Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,862.09 | Facility | None | $851.14 | $1,047.13 | $1,862.09 |
Geisinger Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,584.89 | Professional | None | $575.44 | $812.83 | $1,584.89 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $616.60 | Professional | None | $537.03 | $588.84 | $616.60 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $436.52 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,288.25 | Professional | None | $707.95 | $954.99 | $1,288.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $588.84 Median $1,737.80 Typical High $3,467.37 | Facility | None | $588.84 | $1,737.80 | $3,467.37 |
UPMC Health Plan Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $870.96 | Professional | None | $588.84 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $3,890.45 | Facility | None | $812.83 | $1,318.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,000.00 | Professional | None | $575.44 | $645.65 | $1,000.00 |
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 $269.15 Median $295.12 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $107.15 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $467.74 | Professional | 54 · Surgery only | $407.38 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $61.66 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $933.25 Typical High $1,659.59 | Professional | 50 · Both sides | $912.01 | $933.25 | $1,659.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $288.40 | $309.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $107.15 | $117.49 | $125.89 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $467.74 | Professional | 54 · Surgery only | $407.38 | $436.52 | $467.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $93.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $61.66 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $61.66 |
Where Pennsylvania sits
The same service costs 7.4 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· 45th of 51
$631
AK $2,455TX $331
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.