How much rates vary
Facilitymedian $2,951 · 10th to 90th $692 to $8,128Professionalmedian $741 · 10th to 90th $646 to $1,202
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 $831.76 Median $5,495.41 Typical High $8,709.64 | Facility | None | $831.76 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $758.58 | Professional | None | $645.65 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $467.74 | $524.81 |
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 $724.44 Median $758.58 Typical High $1,288.25 | Professional | None | $724.44 | $758.58 | $1,288.25 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,089.30 Typical High $3,388.44 | Facility | None | $549.54 | $2,089.30 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,513.56 | Professional | None | $630.96 | $724.44 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,174.90 | Professional | None | $870.96 | $1,174.90 | $1,174.90 |
Geisinger Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,548.82 | Professional | None | $676.08 | $891.25 | $1,548.82 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $4,897.79 Typical High $8,709.64 | Facility | None | $912.01 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Professional | None | $645.65 | $676.08 | $758.58 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $467.74 | $524.81 |
Oscar Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,380.38 | Professional | None | $812.83 | $812.83 | $1,380.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $724.44 | Facility | None | $707.95 | $724.44 | $724.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | None | $707.95 | $724.44 | $724.44 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $7,079.46 | Facility | None | $1,698.24 | $3,235.94 | $7,079.46 |
United Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,174.90 | Professional | None | $676.08 | $776.25 | $1,174.90 |
12 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 $323.59 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $75.86 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,122.02 Typical High $1,905.46 | Professional | 50 · Both sides | $1,096.48 | $1,122.02 | $1,905.46 |
Highmark BCBS Setting Facility Modifier 50 · Both sides Typical Low $0.50 Median $0.50 Typical High $114,815.36 | Facility | 50 · Both sides | $0.50 | $0.50 | $114,815.36 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $331.13 | $371.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $134.90 | $151.36 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $501.19 | $562.34 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $112.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $75.86 |
Where Pennsylvania sits
The same service costs 7.6 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· 39th of 51
$759
AK $2,951TX $389
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.