How much rates vary
Facilitymedian $3,890 · 10th to 90th $692 to $8,710Professionalmedian $1,778 · 10th to 90th $1,549 to $3,020
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 $1,548.82 Median $1,659.59 Typical High $1,778.28 | Professional | None | $1,548.82 | $1,659.59 | $1,778.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,230.27 |
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 $1,698.24 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,698.24 | $1,778.28 | $3,311.31 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,230.27 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,230.27 | $2,290.87 |
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 $1,621.81 Median $1,698.24 Typical High $3,715.35 | Professional | None | $1,621.81 | $1,698.24 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,691.53 | $2,691.53 |
Geisinger Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,548.82 | $2,041.74 | $3,715.35 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,548.82 Median $1,659.59 Typical High $1,778.28 | Professional | None | $1,548.82 | $1,659.59 | $1,778.28 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,230.27 |
Oscar Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,949.84 | $2,089.30 | $3,388.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,659.59 | $1,737.80 | $1,737.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,737.80 | $1,737.80 |
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 $1,584.89 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,862.09 | $2,818.38 |
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 $758.58 Median $831.76 Typical High $891.25 | Professional | 52 · Reduced service | $758.58 | $831.76 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $331.13 Typical High $354.81 | Professional | 53 · Discontinued | $309.03 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,258.93 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,148.15 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $251.19 Typical High $263.03 | Professional | 55 · Aftercare only | $229.09 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $165.96 Typical High $177.83 | Professional | 56 · Pre-op care only | $154.88 | $165.96 | $177.83 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $2,630.27 Typical High $4,897.79 | Professional | 50 · Both sides | $2,570.40 | $2,630.27 | $4,897.79 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $831.76 Typical High $891.25 | Professional | 52 · Reduced service | $758.58 | $831.76 | $891.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $331.13 Typical High $354.81 | Professional | 53 · Discontinued | $309.03 | $331.13 | $354.81 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,318.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $263.03 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $263.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $165.96 Typical High $177.83 | Professional | 56 · Pre-op care only | $154.88 | $165.96 | $177.83 |
Where Pennsylvania sits
The same service costs 9.3 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· 43rd of 51
$1,778
AK $6,918TX $741
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.