How much rates vary
Facilitymedian $3,631 · 10th to 90th $692 to $8,710Professionalmedian $2,138 · 10th to 90th $1,096 to $3,631
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 $1,047.13 Median $5,495.41 Typical High $8,709.64 | Facility | None | $1,047.13 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,862.09 | $1,905.46 | $2,137.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,380.38 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,380.38 | $1,479.11 |
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 $2,041.74 Median $2,137.96 Typical High $3,981.07 | Professional | None | $2,041.74 | $2,137.96 | $3,981.07 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,479.11 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,479.11 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,388.44 Typical High $6,025.60 | Facility | None | $549.54 | $3,388.44 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,995.26 Typical High $4,365.16 | Professional | None | $954.99 | $1,995.26 | $4,365.16 |
Emblem Health Setting Professional Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,344.23 | $3,162.28 | $3,162.28 |
Geisinger Setting Professional Modifier None Typical Low $1,023.29 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,023.29 | $2,089.30 | $3,090.30 |
Martin's Point Setting Facility Modifier None Typical Low $1,148.15 Median $5,248.07 Typical High $8,709.64 | Facility | None | $1,148.15 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,862.09 | $1,905.46 | $2,137.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,348.96 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,348.96 | $1,479.11 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,258.93 | $2,344.23 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,995.26 | Facility | None | $1,096.48 | $1,096.48 | $1,995.26 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,096.48 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,000.00 | Facility | None | $1,698.24 | $3,235.94 | $10,000.00 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $2,187.76 Typical High $3,311.31 | Professional | None | $1,023.29 | $2,187.76 | $3,311.31 |
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 $933.25 Median $977.24 Typical High $1,071.52 | Professional | 52 · Reduced service | $933.25 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $389.05 Typical High $426.58 | Professional | 53 · Discontinued | $371.54 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,479.11 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,380.38 | $1,479.11 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $295.12 Typical High $316.23 | Professional | 55 · Aftercare only | $275.42 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $194.98 Typical High $213.80 | Professional | 56 · Pre-op care only | $186.21 | $194.98 | $213.80 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $3,162.28 Typical High $6,025.60 | Professional | 50 · Both sides | $3,090.30 | $3,162.28 | $6,025.60 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $954.99 Typical High $1,071.52 | Professional | 52 · Reduced service | $933.25 | $954.99 | $1,071.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $380.19 Typical High $426.58 | Professional | 53 · Discontinued | $371.54 | $380.19 | $426.58 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,445.44 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,380.38 | $1,445.44 | $1,584.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $288.40 Typical High $316.23 | Professional | 55 · Aftercare only | $275.42 | $288.40 | $316.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $190.55 Typical High $213.80 | Professional | 56 · Pre-op care only | $186.21 | $190.55 | $213.80 |
Where Pennsylvania sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $18,090KY $3,723
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.