How much rates vary
Facilitymedian $2,042 · 10th to 90th $724 to $5,888Professionalmedian $912 · 10th to 90th $851 to $1,318
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 $870.96 Median $4,073.80 Typical High $8,317.64 | Facility | None | $870.96 | $4,073.80 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $977.24 | Professional | None | $851.14 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $691.83 |
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 $1,380.38 Median $1,479.11 Typical High $56,234.13 | Professional | None | $1,380.38 | $1,479.11 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $1,148.15 |
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 $851.14 Median $891.25 Typical High $1,995.26 | Professional | None | $851.14 | $891.25 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,548.82 | $1,548.82 |
Geisinger Setting Facility Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,467.37 | Facility | None | $1,584.89 | $1,995.26 | $3,467.37 |
Geisinger Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,949.84 | Professional | None | $851.14 | $1,148.15 | $1,949.84 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $3,801.89 Typical High $8,317.64 | Facility | None | $954.99 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $977.24 | Professional | None | $851.14 | $891.25 | $977.24 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $691.83 |
Oscar Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,096.48 | $1,737.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $912.01 Median $1,737.80 Typical High $3,388.44 | Facility | None | $912.01 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | None | $912.01 | $933.25 | $933.25 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $5,888.44 | Facility | None | $1,148.15 | $1,905.46 | $5,888.44 |
United Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,445.44 | Professional | None | $812.83 | $977.24 | $1,445.44 |
10 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 $426.58 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $426.58 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $169.82 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $97.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $426.58 | $446.68 | $489.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $169.82 | $177.83 | $199.53 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $660.69 | $741.31 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $147.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $97.72 |
Where Pennsylvania sits
The same service costs 3.1 times more in Alaska than in Hawaii. 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
AK $8,167HI $2,648
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.