How much rates vary
Facilitymedian $3,802 · 10th to 90th $933 to $8,710Professionalmedian $1,072 · 10th to 90th $933 to $1,820
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 $5,495.41 Typical High $8,709.64 | Facility | None | $1,023.29 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,071.52 | Professional | None | $933.25 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $707.95 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $645.65 | $707.95 | $758.58 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,071.52 | $1,949.84 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,801.89 Typical High $8,511.38 | Facility | None | $707.95 | $3,801.89 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $2,238.72 | Professional | None | $954.99 | $1,047.13 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,659.59 | $1,659.59 |
Geisinger Setting Facility Modifier None Typical Low $5,128.61 Median $6,309.57 Typical High $11,220.18 | Facility | None | $5,128.61 | $6,309.57 | $11,220.18 |
Geisinger Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,137.96 | Professional | None | $954.99 | $1,230.27 | $2,137.96 |
Martin's Point Setting Facility Modifier None Typical Low $1,071.52 Median $4,897.79 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,071.52 | Professional | None | $933.25 | $1,023.29 | $1,071.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $707.95 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $645.65 | $707.95 | $758.58 |
Oscar Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,288.25 | $1,995.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,023.29 Median $3,235.94 Typical High $6,456.54 | Facility | None | $1,023.29 | $3,235.94 | $6,456.54 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,023.29 | $1,071.52 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,698.24 | Professional | None | $977.24 | $1,122.02 | $1,698.24 |
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 $467.74 Median $512.86 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $204.17 Typical High $213.80 | Professional | 53 · Discontinued | $186.21 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $691.83 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $102.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $102.33 | $107.15 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,621.81 Typical High $2,951.21 | Professional | 50 · Both sides | $1,548.82 | $1,621.81 | $2,951.21 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $501.19 | $537.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $213.80 | Professional | 53 · Discontinued | $186.21 | $199.53 | $213.80 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $691.83 | $758.58 | $812.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $162.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $107.15 |
Where Pennsylvania sits
The same service costs 7.9 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
$1,072
AK $4,266TX $537
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.