How much rates vary
Facilitymedian $2,291 · 10th to 90th $676 to $6,166Professionalmedian $1,000 · 10th to 90th $912 to $1,413
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 $933.25 Median $3,235.94 Typical High $8,511.38 | Facility | None | $933.25 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,047.13 | Professional | None | $912.01 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $741.31 |
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 $1,479.11 Median $1,584.89 Typical High $56,234.13 | Professional | None | $1,479.11 | $1,584.89 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $724.44 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $691.83 | $724.44 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,584.89 Typical High $2,691.53 | Facility | None | $489.78 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $2,187.76 | Professional | None | $912.01 | $977.24 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,621.81 | $1,621.81 |
Geisinger Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $2,041.74 | Professional | None | $912.01 | $1,230.27 | $2,041.74 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $8,317.64 | Facility | None | $954.99 | $2,818.38 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,047.13 | Professional | None | $912.01 | $977.24 | $1,047.13 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $741.31 |
Oscar Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,348.96 | $1,905.46 |
UPMC Health Plan Setting Facility Modifier None Typical Low $977.24 Median $1,548.82 Typical High $2,630.27 | Facility | None | $977.24 | $1,548.82 | $2,630.27 |
UPMC Health Plan Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | None | $977.24 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,309.57 | Facility | None | $1,380.38 | $2,398.83 | $6,309.57 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,621.81 | Professional | None | $912.01 | $1,071.52 | $1,621.81 |
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 $457.09 Median $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $457.09 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $181.97 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $794.33 | Professional | 54 · Surgery only | $676.08 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $104.71 |
Highmark BCBS Setting Professional Modifier 51 · Multiple procedures Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $1,023.29 | $1,023.29 | $1,023.29 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $457.09 | $489.78 | $524.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $181.97 | $194.98 | $208.93 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $794.33 | Professional | 54 · Surgery only | $676.08 | $741.31 | $794.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $158.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $104.71 |
Where Pennsylvania sits
The same service costs 4.6 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.
Physician feeFacility fee
AK $9,923TX $2,157
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.