How much rates vary
Facilitymedian $3,631 · 10th to 90th $741 to $7,943Professionalmedian $955 · 10th to 90th $851 to $1,660
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 $851.14 Median $3,801.89 Typical High $8,317.64 | Facility | None | $851.14 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $954.99 | Professional | None | $831.76 | $891.25 | $954.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $676.08 |
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 $912.01 Median $954.99 Typical High $1,737.80 | Professional | None | $912.01 | $954.99 | $1,737.80 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $1,202.26 |
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 $891.25 Median $977.24 Typical High $1,995.26 | Professional | None | $891.25 | $977.24 | $1,995.26 |
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 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 $851.14 Median $1,202.26 Typical High $2,290.87 | Professional | None | $851.14 | $1,202.26 | $2,290.87 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $3,715.35 Typical High $8,317.64 | Facility | None | $954.99 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $954.99 | Professional | None | $831.76 | $891.25 | $954.99 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $676.08 |
Oscar Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,318.26 | $1,905.46 |
UPMC Health Plan Setting Facility Modifier None Typical Low $891.25 Median $1,737.80 Typical High $3,388.44 | Facility | None | $891.25 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,148.15 | Professional | None | $891.25 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,000.00 | Facility | None | $1,698.24 | $3,235.94 | $10,000.00 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,513.56 | Professional | None | $870.96 | $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 $446.68 Typical High $478.63 | Professional | 52 · Reduced service | $416.87 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $165.96 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $724.44 | Professional | 54 · Surgery only | $616.60 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $95.50 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $95.50 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,445.44 Typical High $2,630.27 | Professional | 50 · Both sides | $1,380.38 | $1,445.44 | $2,630.27 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $446.68 Typical High $478.63 | Professional | 52 · Reduced service | $416.87 | $446.68 | $478.63 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $190.55 | Professional | 53 · Discontinued | $165.96 | $177.83 | $190.55 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $724.44 | Professional | 54 · Surgery only | $616.60 | $676.08 | $724.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $144.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $95.50 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $95.50 |
Where Pennsylvania sits
The same service costs 14.5 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
$955
AK $3,715TX $257
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.