How much rates vary
Facilitymedian $1,096 · 10th to 90th $490 to $4,677Professionalmedian $339 · 10th to 90th $288 to $575
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 $645.65 Median $3,235.94 Typical High $8,511.38 | Facility | None | $645.65 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $338.84 | Professional | None | $288.40 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $218.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $204.17 | $218.78 | $234.42 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $56,234.13 | Facility | None | $3,981.07 | $4,365.16 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $588.84 | Professional | None | $331.13 | $338.84 | $588.84 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $234.42 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $229.09 | $234.42 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $870.96 Typical High $1,698.24 | Facility | None | $478.63 | $870.96 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $691.83 | Professional | None | $269.15 | $316.23 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $537.03 | Professional | None | $398.11 | $537.03 | $537.03 |
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 $281.84 Median $389.05 Typical High $630.96 | Professional | None | $281.84 | $389.05 | $630.96 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,818.38 Typical High $8,317.64 | Facility | None | $724.44 | $2,818.38 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $338.84 | Professional | None | $288.40 | $302.00 | $338.84 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $208.93 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $204.17 | $208.93 | $234.42 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $602.56 | Professional | None | $389.05 | $562.34 | $602.56 |
UPMC Health Plan Setting Facility Modifier None Typical Low $316.23 Median $1,513.56 Typical High $2,951.21 | Facility | None | $316.23 | $1,513.56 | $2,951.21 |
UPMC Health Plan Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $549.54 | Professional | None | $316.23 | $549.54 | $549.54 |
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 $275.42 Median $346.74 Typical High $524.81 | Professional | None | $275.42 | $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 $144.54 Median $154.88 Typical High $169.82 | Professional | 52 · Reduced service | $144.54 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $61.66 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $218.78 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.90 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $30.90 | $33.88 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $512.86 Typical High $891.25 | Professional | 50 · Both sides | $489.78 | $512.86 | $891.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $147.91 Typical High $169.82 | Professional | 52 · Reduced service | $144.54 | $147.91 | $169.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $60.26 | $67.61 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $218.78 | $223.87 | $251.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $44.67 | $50.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $33.88 |
Where Pennsylvania sits
The same service costs 4.6 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,822MT $1,050
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.