How much rates vary
Facilitymedian $3,311 · 10th to 90th $661 to $7,079Professionalmedian $617 · 10th to 90th $550 to $871
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 $676.08 Median $4,073.80 Typical High $8,317.64 | Facility | None | $676.08 | $4,073.80 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $630.96 | Professional | None | $549.54 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $446.68 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $56,234.13 | Professional | None | $891.25 | $954.99 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $436.52 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $426.58 | $436.52 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $5,888.44 | Facility | None | $501.19 | $2,691.53 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,318.26 | Professional | None | $562.34 | $616.60 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,000.00 | Professional | None | $741.31 | $1,000.00 | $1,000.00 |
Geisinger Setting Facility Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $7,943.28 | Facility | None | $3,630.78 | $4,466.84 | $7,943.28 |
Geisinger Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,258.93 | Professional | None | $562.34 | $741.31 | $1,258.93 |
Highmark BCBS Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $630.96 | Professional | None | $549.54 | $602.56 | $630.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $446.68 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,174.90 | Professional | None | $707.95 | $933.25 | $1,174.90 |
UPMC Health Plan Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $3,388.44 | Facility | None | $602.56 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $851.14 | Professional | None | $602.56 | $851.14 | $851.14 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $977.24 | Professional | None | $562.34 | $660.69 | $977.24 |
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 $275.42 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $478.63 | Professional | 54 · Surgery only | $407.38 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $63.10 |
Highmark BCBS Setting Facility Modifier 59 · Distinct service Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | 59 · Distinct service | $5,370.32 | $5,370.32 | $5,370.32 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $295.12 | $316.23 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $117.49 | $125.89 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $478.63 | Professional | 54 · Surgery only | $407.38 | $446.68 | $478.63 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $95.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $63.10 |
Where Pennsylvania sits
The same service costs 8.1 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· 44th of 51
$631
AK $2,512TX $309
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.