How much rates vary
Facilitymedian $229 · 10th to 90th $78 to $3,631Professionalmedian $302 · 10th to 90th $257 to $501
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 $323.59 Median $2,344.23 Typical High $8,317.64 | Facility | None | $323.59 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $338.84 | Professional | None | $257.04 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $229.09 |
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 $316.23 Median $331.13 Typical High $562.34 | Professional | None | $316.23 | $331.13 | $562.34 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $229.09 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $218.78 | $229.09 | $389.05 |
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 $239.88 Median $295.12 Typical High $537.03 | Professional | None | $239.88 | $295.12 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $588.84 | Professional | None | $446.68 | $588.84 | $588.84 |
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 $269.15 Median $389.05 Typical High $630.96 | Professional | None | $269.15 | $389.05 | $630.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $295.12 Median $436.52 Typical High $549.54 | Facility | None | $295.12 | $436.52 | $549.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $426.58 | Professional | None | $229.09 | $338.84 | $426.58 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,344.23 Typical High $7,244.36 | Facility | None | $478.63 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $323.59 | Professional | None | $257.04 | $288.40 | $323.59 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $229.09 |
Oscar Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $575.44 | Professional | None | $323.59 | $323.59 | $575.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $158.49 Median $263.03 Typical High $309.03 | Facility | None | $158.49 | $263.03 | $309.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $302.00 | Professional | None | $229.09 | $275.42 | $302.00 |
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 $316.23 Typical High $478.63 | Professional | None | $251.19 | $316.23 | $478.63 |
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 $128.82 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $128.82 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $51.29 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $194.98 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $32.36 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $489.78 Typical High $851.14 | Professional | 50 · Both sides | $478.63 | $489.78 | $851.14 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $128.82 | $144.54 | $162.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $51.29 | $57.54 | $64.57 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $194.98 | $213.80 | $245.47 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $48.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $32.36 |
Where Pennsylvania sits
The same service costs 5.8 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· 37th of 51
$302
AK $1,202TX $209
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.