How much rates vary
Facilitymedian $3,890 · 10th to 90th $692 to $8,710Professionalmedian $1,514 · 10th to 90th $1,318 to $2,570
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 $1,318.26 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,445.44 | $1,513.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,071.52 |
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 $1,513.56 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,513.56 | $2,818.38 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,047.13 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,047.13 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,365.16 Typical High $7,585.78 | Facility | None | $549.54 | $4,365.16 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $3,162.28 | Professional | None | $1,380.38 | $1,479.11 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,698.24 | $2,290.87 | $2,290.87 |
Geisinger Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,348.96 | $1,737.80 | $3,090.30 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.50 Median $0.50 Typical High $15,135.61 | Facility | None | $0.50 | $0.50 | $15,135.61 |
Highmark BCBS Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
Martin's Point Setting Facility Modifier None Typical Low $1,148.15 Median $4,897.79 Typical High $8,709.64 | Facility | None | $1,148.15 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,445.44 | $1,513.56 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,071.52 |
Oscar Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,698.24 | $1,778.28 | $2,951.21 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,412.54 | $1,584.89 | $1,584.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,412.54 | $1,584.89 | $1,584.89 |
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 $1,380.38 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,621.81 | $2,398.83 |
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 $660.69 Median $707.95 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $229.09 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $151.36 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,290.87 Typical High $4,265.80 | Professional | 50 · Both sides | $2,187.76 | $2,290.87 | $4,265.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $707.95 | $758.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $281.84 | $302.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,148.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $229.09 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $229.09 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $151.36 |
Where Pennsylvania sits
The same service costs 8.7 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
$1,514
AK $5,888TX $676
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.