How much rates vary
Facilitymedian $3,236 · 10th to 90th $724 to $7,244Professionalmedian $794 · 10th to 90th $724 to $1,445
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 $794.33 Median $3,890.45 Typical High $8,317.64 | Facility | None | $794.33 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $794.33 | Professional | None | $691.83 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $524.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $489.78 | $524.81 | $562.34 |
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 $776.25 Median $812.83 Typical High $1,479.11 | Professional | None | $776.25 | $812.83 | $1,479.11 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $5,888.44 | Facility | None | $501.19 | $2,691.53 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,698.24 | Professional | None | $741.31 | $851.14 | $1,698.24 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | None | $933.25 | $1,258.93 | $1,258.93 |
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 $724.44 Median $1,023.29 Typical High $1,949.84 | Professional | None | $724.44 | $1,023.29 | $1,949.84 |
Martin's Point Setting Facility Modifier None Typical Low $794.33 Median $3,801.89 Typical High $8,317.64 | Facility | None | $794.33 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $794.33 | Professional | None | $691.83 | $758.58 | $794.33 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $524.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $489.78 | $524.81 | $562.34 |
Oscar Health Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,659.59 | Professional | None | $891.25 | $1,148.15 | $1,659.59 |
UPMC Health Plan Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $3,388.44 | Facility | None | $758.58 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,047.13 | Professional | None | $758.58 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,288.25 | Professional | None | $741.31 | $831.76 | $1,288.25 |
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 $346.74 Median $380.19 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $524.81 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $120.23 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $79.43 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,202.26 Typical High $2,187.76 | Professional | 50 · Both sides | $1,174.90 | $1,202.26 | $2,187.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $371.54 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $371.54 | $398.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $151.36 | $162.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $524.81 | $562.34 | $602.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $120.23 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $120.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $79.43 |
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· 44th of 51
$813
AK $3,162TX $417
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.