How much rates vary
Facilitymedian $2,455 · 10th to 90th $631 to $7,244Professionalmedian $724 · 10th to 90th $631 to $1,202
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 $724.44 Median $4,897.79 Typical High $8,511.38 | Facility | None | $724.44 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $758.58 | Professional | None | $645.65 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $467.74 | $524.81 |
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 $707.95 Median $741.31 Typical High $1,258.93 | Professional | None | $707.95 | $741.31 | $1,258.93 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,584.89 Typical High $2,691.53 | Facility | None | $501.19 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,548.82 | Professional | None | $630.96 | $691.83 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,174.90 | Professional | None | $870.96 | $1,174.90 | $1,174.90 |
Geisinger Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,445.44 | Professional | None | $645.65 | $851.14 | $1,445.44 |
Martin's Point Setting Facility Modifier None Typical Low $758.58 Median $4,897.79 Typical High $8,709.64 | Facility | None | $758.58 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $758.58 | Professional | None | $645.65 | $660.69 | $758.58 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $467.74 | $524.81 |
Oscar Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,318.26 | Professional | None | $812.83 | $812.83 | $1,318.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Facility | None | $691.83 | $691.83 | $707.95 |
UPMC Health Plan Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | None | $691.83 | $691.83 | $707.95 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $7,079.46 | Facility | None | $1,698.24 | $3,235.94 | $7,079.46 |
United Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,122.02 | Professional | None | $630.96 | $758.58 | $1,122.02 |
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 $323.59 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $75.86 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,122.02 Typical High $1,905.46 | Professional | 50 · Both sides | $1,071.52 | $1,122.02 | $1,905.46 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $331.13 | $371.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $134.90 | $151.36 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $501.19 | $562.34 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $112.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $75.86 |
Where Pennsylvania sits
The same service costs 19.5 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· 41st of 51
$741
AK $2,951TX $151
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.