How much rates vary
Facilitymedian $1,413 · 10th to 90th $501 to $5,495Professionalmedian $1,413 · 10th to 90th $1,023 to $2,455
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 $891.25 Median $3,890.45 Typical High $8,317.64 | Facility | None | $891.25 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,318.26 | $1,412.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $933.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $933.25 | $977.24 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,479.11 | $2,570.40 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,202.26 Typical High $2,290.87 | Facility | None | $501.19 | $1,202.26 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,380.38 Typical High $2,951.21 | Professional | None | $933.25 | $1,380.38 | $2,951.21 |
Emblem Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,659.59 | $2,238.72 | $2,238.72 |
Geisinger Setting Facility Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,630.27 | Facility | None | $1,202.26 | $1,513.56 | $2,630.27 |
Geisinger Setting Professional Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,398.83 | Professional | None | $954.99 | $1,584.89 | $2,398.83 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $3,801.89 Typical High $8,317.64 | Facility | None | $954.99 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,258.93 | $1,412.54 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $870.96 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $870.96 | $977.24 |
Oscar Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,949.84 | Professional | None | $1,230.27 | $1,230.27 | $1,949.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,023.29 | $1,318.26 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,981.07 | Facility | None | $416.87 | $724.44 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,445.44 | $2,187.76 |
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 $602.56 Median $660.69 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,000.00 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $1,000.00 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $199.53 Typical High $208.93 | Professional | 55 · Aftercare only | $181.97 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $141.25 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,238.72 Typical High $3,890.45 | Professional | 50 · Both sides | $2,137.96 | $2,238.72 | $3,890.45 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $630.96 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $630.96 | $707.95 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $251.19 | $281.84 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $933.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $933.25 | $1,047.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $208.93 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $141.25 |
Where Pennsylvania sits
The same service costs 3.7 times more in Alaska 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
AK $8,917DE $2,410
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.