How much rates vary
Facilitymedian $1,023 · 10th to 90th $437 to $4,677Professionalmedian $513 · 10th to 90th $447 to $891
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 $537.03 Median $2,344.23 Typical High $8,317.64 | Facility | None | $537.03 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $512.86 | Professional | None | $446.68 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $309.03 | $338.84 | $363.08 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $891.25 | Professional | None | $501.19 | $524.81 | $891.25 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $812.83 Typical High $1,445.44 | Facility | None | $338.84 | $812.83 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $1,071.52 | Professional | None | $426.58 | $478.63 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $831.76 | Professional | None | $616.60 | $831.76 | $831.76 |
Geisinger Setting Facility Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,862.09 | Facility | None | $851.14 | $1,047.13 | $1,862.09 |
Geisinger Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $1,000.00 | Professional | None | $457.09 | $602.56 | $1,000.00 |
Martin's Point Setting Facility Modifier None Typical Low $537.03 Median $2,344.23 Typical High $7,244.36 | Facility | None | $537.03 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $512.86 | Professional | None | $446.68 | $467.74 | $512.86 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $323.59 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $309.03 | $323.59 | $363.08 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $891.25 | Professional | None | $562.34 | $562.34 | $891.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $467.74 Median $1,122.02 Typical High $2,238.72 | Facility | None | $467.74 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | None | $467.74 | $467.74 | $489.78 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,548.13 | Facility | None | $416.87 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $794.33 | Professional | None | $426.58 | $524.81 | $794.33 |
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 $223.87 Median $239.88 Typical High $257.04 | Professional | 52 · Reduced service | $223.87 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $66.07 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $47.86 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $47.86 | $51.29 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $776.25 Typical High $1,348.96 | Professional | 50 · Both sides | $758.58 | $776.25 | $1,348.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $223.87 | $234.42 | $257.04 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $93.33 | $104.71 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $346.74 | $389.05 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $77.62 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $77.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $51.29 |
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· 42nd of 51
$513
AK $2,042TX $269
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.