How much rates vary
Facilitymedian $245 · 10th to 90th $83 to $3,631Professionalmedian $110 · 10th to 90th $72 to $178
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 $123.03 Median $2,344.23 Typical High $8,317.64 | Facility | None | $123.03 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $123.03 | Professional | None | $70.79 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $70.79 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $48.98 | $70.79 | $87.10 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $56,234.13 | Facility | None | $2,511.89 | $2,570.40 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $204.17 | Professional | None | $114.82 | $120.23 | $204.17 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $95.50 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $93.33 | $95.50 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $302.00 Typical High $691.83 | Facility | None | $95.50 | $302.00 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $173.78 | Professional | None | $75.86 | $100.00 | $173.78 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $213.80 | Professional | None | $158.49 | $213.80 | $213.80 |
Geisinger Setting Facility Modifier None Typical Low $87.10 Median $109.65 Typical High $190.55 | Facility | None | $87.10 | $109.65 | $190.55 |
Geisinger Setting Professional Modifier None Typical Low $69.18 Median $117.49 Typical High $204.17 | Professional | None | $69.18 | $117.49 | $204.17 |
Highmark BCBS Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $588.84 | Facility | None | $173.78 | $173.78 | $588.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $138.04 | Professional | None | $112.20 | $120.23 | $138.04 |
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 $70.79 Median $100.00 Typical High $123.03 | Professional | None | $70.79 | $100.00 | $123.03 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $70.79 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $48.98 | $70.79 | $87.10 |
Oscar Health Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $208.93 | Professional | None | $72.44 | $112.20 | $208.93 |
UPMC Health Plan Setting Facility Modifier None Typical Low $66.07 Median $75.86 Typical High $114.82 | Facility | None | $66.07 | $75.86 | $114.82 |
UPMC Health Plan Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $114.82 | Professional | None | $66.07 | $87.10 | $114.82 |
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 $75.86 Median $104.71 Typical High $151.36 | Professional | None | $75.86 | $104.71 | $151.36 |
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 $35.48 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $35.48 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $14.13 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $52.48 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $10.47 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.08 | $10.00 | $12.30 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $177.83 Typical High $302.00 | Professional | 50 · Both sides | $173.78 | $177.83 | $302.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $35.48 | $50.12 | $61.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $14.13 | $19.95 | $24.55 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $52.48 | $75.86 | $93.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $10.47 | $15.14 | $18.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.08 | $10.00 | $12.30 |
Where Pennsylvania sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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
$110
AK $324KY $87.10
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.