How much rates vary
Facilitymedian $933 · 10th to 90th $331 to $3,981Professionalmedian $724 · 10th to 90th $646 to $1,259
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 $741.31 Median $3,090.30 Typical High $8,511.38 | Facility | None | $741.31 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $741.31 | Professional | None | $645.65 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $489.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $489.78 | $512.86 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,630.27 Median $2,818.38 Typical High $8,709.64 | Facility | None | $2,630.27 | $2,818.38 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,318.26 | Professional | None | $707.95 | $741.31 | $1,318.26 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $776.25 Typical High $1,445.44 | Facility | None | $478.63 | $776.25 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $1,548.82 | Professional | None | $645.65 | $707.95 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
Geisinger Setting Facility Modifier None Typical Low $724.44 Median $891.25 Typical High $1,584.89 | Facility | None | $724.44 | $891.25 | $1,584.89 |
Geisinger Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,445.44 | Professional | None | $645.65 | $851.14 | $1,445.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,162.28 | Facility | None | $3,019.95 | $3,019.95 | $3,162.28 |
Martin's Point Setting Facility Modifier None Typical Low $741.31 Median $2,754.23 Typical High $8,317.64 | Facility | None | $741.31 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $741.31 | Professional | None | $645.65 | $676.08 | $741.31 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $512.86 |
Oscar Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,348.96 | Professional | None | $776.25 | $776.25 | $1,348.96 |
UPMC Health Plan Setting Facility Modifier None Typical Low $691.83 Median $1,513.56 Typical High $2,951.21 | Facility | None | $691.83 | $1,513.56 | $2,951.21 |
UPMC Health Plan Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $3,467.37 | Facility | None | $199.53 | $436.52 | $3,467.37 |
United Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,148.15 | Professional | None | $660.69 | $758.58 | $1,148.15 |
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 $316.23 Median $346.74 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $138.04 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $69.18 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $69.18 | $74.13 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,096.48 Typical High $1,995.26 | Professional | 50 · Both sides | $1,071.52 | $1,096.48 | $1,995.26 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $346.74 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $346.74 | $371.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $138.04 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $138.04 | $147.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $512.86 | $549.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $109.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $69.18 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $69.18 | $74.13 |
Where Pennsylvania sits
The same service costs 3.6 times more in Colorado than in Delaware. 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
CO $4,868DE $1,354
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.