How much rates vary
Facilitymedian $347 · 10th to 90th $85 to $3,890Professionalmedian $347 · 10th to 90th $263 to $589
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 $354.81 Median $812.83 Typical High $6,165.95 | Facility | None | $354.81 | $812.83 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $436.52 | Professional | None | $295.12 | $331.13 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $218.78 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $204.17 | $218.78 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
AmeriHealth Setting Facility Modifier None Typical Low $1,778.28 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,778.28 | $2,884.03 | $5,888.44 |
AmeriHealth Setting Professional Modifier None Typical Low $177.83 Median $363.08 Typical High $398.11 | Professional | None | $177.83 | $363.08 | $398.11 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $630.96 | Professional | None | $346.74 | $489.78 | $630.96 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $338.84 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $239.88 | $338.84 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $147.91 Typical High $275.42 | Facility | None | $50.12 | $147.91 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $575.44 | Professional | None | $229.09 | $323.59 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $660.69 | Professional | None | $489.78 | $660.69 | $660.69 |
Geisinger Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $288.40 | Facility | None | $131.83 | $165.96 | $288.40 |
Geisinger Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $645.65 | Professional | None | $257.04 | $416.87 | $645.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $295.12 Median $630.96 Typical High $1,258.93 | Facility | None | $295.12 | $630.96 | $1,258.93 |
Highmark BCBS Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $446.68 | Professional | None | $323.59 | $371.54 | $446.68 |
Independence Blue Cross Setting Facility Modifier None Typical Low $691.83 Median $3,890.45 Typical High $6,760.83 | Facility | None | $691.83 | $3,890.45 | $6,760.83 |
Independence Blue Cross Setting Professional Modifier None Typical Low $177.83 Median $363.08 Typical High $398.11 | Professional | None | $177.83 | $363.08 | $398.11 |
Martin's Point Setting Facility Modifier None Typical Low $354.81 Median $1,047.13 Typical High $6,165.95 | Facility | None | $354.81 | $1,047.13 | $6,165.95 |
Martin's Point Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $416.87 | Professional | None | $295.12 | $316.23 | $416.87 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $218.78 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $204.17 | $218.78 | $251.19 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $549.54 | Professional | None | $316.23 | $316.23 | $549.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $223.87 Median $323.59 Typical High $436.52 | Facility | None | $223.87 | $323.59 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $338.84 | Professional | None | $269.15 | $295.12 | $338.84 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $524.81 | Professional | None | $251.19 | $346.74 | $524.81 |
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 $147.91 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $147.91 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $72.44 | Professional | 53 · Discontinued | $58.88 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $234.42 Typical High $269.15 | Professional | 54 · Surgery only | $218.78 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $47.86 Typical High $53.70 | Professional | 55 · Aftercare only | $43.65 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $36.31 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $724.44 Typical High $933.25 | Professional | 50 · Both sides | $524.81 | $724.44 | $933.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $158.49 Typical High $177.83 | Professional | 52 · Reduced service | $147.91 | $158.49 | $177.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $72.44 | Professional | 53 · Discontinued | $58.88 | $63.10 | $72.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $234.42 Typical High $269.15 | Professional | 54 · Surgery only | $218.78 | $234.42 | $269.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $47.86 Typical High $53.70 | Professional | 55 · Aftercare only | $43.65 | $47.86 | $53.70 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $36.31 |
Where Pennsylvania sits
The same service costs 5.6 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· 39th of 51
$347
AK $1,380TX $245
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.