How much rates vary
Facilitymedian $2,951 · 10th to 90th $692 to $8,511Professionalmedian $3,890 · 10th to 90th $3,467 to $6,457
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 $1,023.29 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,981.07 | Professional | None | $3,467.37 | $3,548.13 | $3,981.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,511.89 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,511.89 | $2,754.23 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,760.83 | Professional | None | $3,801.89 | $3,890.45 | $6,760.83 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,691.53 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,691.53 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $2,691.53 Typical High $7,585.78 | Facility | None | $489.78 | $2,691.53 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $3,801.89 Typical High $8,128.31 | Professional | None | $3,388.44 | $3,801.89 | $8,128.31 |
Emblem Health Setting Professional Modifier None Typical Low $4,365.16 Median $5,888.44 Typical High $5,888.44 | Professional | None | $4,365.16 | $5,888.44 | $5,888.44 |
Geisinger Setting Professional Modifier None Typical Low $3,311.31 Median $4,365.16 Typical High $10,232.93 | Professional | None | $3,311.31 | $4,365.16 | $10,232.93 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $4,786.30 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,786.30 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,981.07 | Professional | None | $3,467.37 | $3,548.13 | $3,981.07 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,511.89 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,511.89 | $2,754.23 |
Oscar Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,466.84 Typical High $7,244.36 | Professional | None | $4,365.16 | $4,466.84 | $7,244.36 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $4,677.35 | Facility | None | $1,318.26 | $2,137.96 | $4,677.35 |
UPMC Health Plan Setting Professional Modifier None Typical Low $3,715.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $3,715.35 | $4,677.35 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $6,165.95 | Professional | None | $3,548.13 | $4,168.69 | $6,165.95 |
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 $1,737.80 Median $1,778.28 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,737.80 | $1,778.28 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $707.95 Typical High $794.33 | Professional | 53 · Discontinued | $691.83 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,691.53 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,570.40 | $2,691.53 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $537.03 Typical High $588.84 | Professional | 55 · Aftercare only | $512.86 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $354.81 Typical High $398.11 | Professional | 56 · Pre-op care only | $346.74 | $354.81 | $398.11 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $5,623.41 Median $5,888.44 Typical High $10,232.93 | Professional | 50 · Both sides | $5,623.41 | $5,888.44 | $10,232.93 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,737.80 Median $1,778.28 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,737.80 | $1,778.28 | $1,995.26 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $707.95 Typical High $794.33 | Professional | 53 · Discontinued | $691.83 | $707.95 | $794.33 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,691.53 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,570.40 | $2,691.53 | $2,951.21 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $537.03 Typical High $588.84 | Professional | 55 · Aftercare only | $512.86 | $537.03 | $588.84 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $354.81 Typical High $398.11 | Professional | 56 · Pre-op care only | $346.74 | $354.81 | $398.11 |
Where Pennsylvania sits
The same service costs 20.4 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· 39th of 51
$3,890
AK $15,488TX $759
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.