How much rates vary
Facilitymedian $4,365 · 10th to 90th $891 to $8,710Professionalmedian $1,202 · 10th to 90th $1,072 to $2,089
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 $1,023.29 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,148.15 | $1,202.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $794.33 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $794.33 | $851.14 |
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 $1,174.90 Median $1,202.26 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,202.26 | $2,238.72 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $831.76 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $812.83 | $831.76 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,311.31 Typical High $8,317.64 | Facility | None | $616.60 | $3,311.31 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,230.27 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,862.09 | $1,862.09 |
Geisinger Setting Facility Modifier None Typical Low $5,011.87 Median $6,165.95 Typical High $10,964.78 | Facility | None | $5,011.87 | $6,165.95 | $10,964.78 |
Geisinger Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,479.11 | $2,818.38 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,148.15 | $1,202.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $794.33 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $794.33 | $851.14 |
Oscar Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,621.81 | $2,454.71 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,148.15 Median $2,137.96 Typical High $4,265.80 | Facility | None | $1,148.15 | $2,137.96 | $4,265.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,412.54 | $1,412.54 |
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 $1,122.02 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,288.25 | $1,905.46 |
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 $524.81 Median $575.44 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $229.09 Typical High $239.88 | Professional | 53 · Discontinued | $208.93 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $851.14 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $104.71 | $114.82 | $120.23 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $1,819.70 Typical High $3,311.31 | Professional | 50 · Both sides | $1,737.80 | $1,819.70 | $3,311.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $562.34 | $602.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $229.09 Typical High $239.88 | Professional | 53 · Discontinued | $208.93 | $229.09 | $239.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $851.14 | $912.01 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $181.97 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $112.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $104.71 | $112.20 | $120.23 |
Where Pennsylvania sits
The same service costs 8.3 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
$1,202
AK $4,786TX $575
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.