How much rates vary
Facilitymedian $2,042 · 10th to 90th $724 to $5,888Professionalmedian $813 · 10th to 90th $776 to $1,148
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 $831.76 Median $4,073.80 Typical High $8,317.64 | Facility | None | $831.76 | $4,073.80 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $891.25 | Professional | None | $776.25 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $630.96 |
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 $1,230.27 Median $1,348.96 Typical High $56,234.13 | Professional | None | $1,230.27 | $1,348.96 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $1,047.13 |
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 $776.25 Median $812.83 Typical High $1,819.70 | Professional | None | $776.25 | $812.83 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,412.54 | $1,412.54 |
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 $776.25 Median $1,047.13 Typical High $1,778.28 | Professional | None | $776.25 | $1,047.13 | $1,778.28 |
Martin's Point Setting Facility Modifier None Typical Low $891.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $891.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $891.25 | Professional | None | $776.25 | $812.83 | $891.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $630.96 |
Oscar Health Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,584.89 | Professional | None | $977.24 | $1,000.00 | $1,584.89 |
UPMC Health Plan Setting Facility Modifier None Typical Low $812.83 Median $1,737.80 Typical High $3,467.37 | Facility | None | $812.83 | $1,737.80 | $3,467.37 |
UPMC Health Plan Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | None | $812.83 | $812.83 | $831.76 |
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 $724.44 Median $870.96 Typical High $1,318.26 | Professional | None | $724.44 | $870.96 | $1,318.26 |
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 $380.19 Median $407.38 Typical High $446.68 | Professional | 52 · Reduced service | $380.19 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $177.83 | Professional | 53 · Discontinued | $154.88 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $575.44 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $89.13 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $89.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $407.38 Typical High $446.68 | Professional | 52 · Reduced service | $380.19 | $407.38 | $446.68 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $177.83 | Professional | 53 · Discontinued | $154.88 | $162.18 | $177.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $575.44 | $602.56 | $676.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $134.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $89.13 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $89.13 |
Where Pennsylvania sits
The same service costs 7.4 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· 43rd of 51
$832
AK $3,467TX $468
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.