How much rates vary
Facilitymedian $1,622 · 10th to 90th $501 to $4,898Professionalmedian $794 · 10th to 90th $692 to $1,096
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 $3,090.30 Typical High $8,511.38 | Facility | None | $870.96 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $870.96 | Professional | None | $741.31 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $537.03 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $537.03 | $602.56 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $8,709.64 | Facility | None | $3,981.07 | $4,365.16 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $56,234.13 | Professional | None | $1,202.26 | $1,288.25 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,548.82 Typical High $2,630.27 | Facility | None | $478.63 | $1,548.82 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,737.80 | Professional | None | $691.83 | $794.33 | $1,737.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,380.38 | $1,380.38 |
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 $741.31 Median $977.24 Typical High $1,621.81 | Professional | None | $741.31 | $977.24 | $1,621.81 |
Martin's Point Setting Facility Modifier None Typical Low $870.96 Median $2,754.23 Typical High $8,317.64 | Facility | None | $870.96 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $870.96 | Professional | None | $741.31 | $776.25 | $870.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $537.03 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $537.03 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,445.44 | Professional | None | $831.76 | $831.76 | $1,445.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $3,019.95 | Facility | None | $758.58 | $1,513.56 | $3,019.95 |
UPMC Health Plan Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $812.83 | Professional | None | $758.58 | $758.58 | $812.83 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $4,265.80 | Facility | None | $416.87 | $724.44 | $4,265.80 |
United Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,258.93 | Professional | None | $676.08 | $851.14 | $1,258.93 |
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 $371.54 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $371.54 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $173.78 | Professional | 53 · Discontinued | $147.91 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $575.44 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $114.82 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $87.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $371.54 | $380.19 | $436.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $173.78 | Professional | 53 · Discontinued | $147.91 | $154.88 | $173.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $575.44 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $575.44 | $645.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $114.82 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $114.82 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $87.10 |
Where Pennsylvania sits
The same service costs 8.3 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· 42nd of 51
$813
AK $3,388TX $407
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.