How much rates vary
Facilitymedian $1,072 · 10th to 90th $490 to $5,129Professionalmedian $759 · 10th to 90th $661 to $1,318
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 $724.44 Median $2,454.71 Typical High $8,317.64 | Facility | None | $724.44 | $2,454.71 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $758.58 | Professional | None | $660.69 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $512.86 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $512.86 | $537.03 |
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 $741.31 Median $758.58 Typical High $1,445.44 | Professional | None | $741.31 | $758.58 | $1,445.44 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $1,778.28 | Facility | None | $549.54 | $891.25 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,584.89 | Professional | None | $707.95 | $741.31 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,202.26 | Professional | None | $891.25 | $1,202.26 | $1,202.26 |
Geisinger Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,659.59 | Professional | None | $707.95 | $912.01 | $1,659.59 |
Martin's Point Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $7,244.36 | Facility | None | $758.58 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | None | $660.69 | $707.95 | $758.58 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,548.82 | Professional | None | $831.76 | $933.25 | $1,548.82 |
UPMC Health Plan Setting Facility Modifier None Typical Low $707.95 Median $2,511.89 Typical High $3,981.07 | Facility | None | $707.95 | $2,511.89 | $3,981.07 |
UPMC Health Plan Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | None | $707.95 | $794.33 | $794.33 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,548.13 | Facility | None | $416.87 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,230.27 | Professional | None | $707.95 | $812.83 | $1,230.27 |
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 $331.13 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $549.54 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $75.86 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,148.15 Typical High $2,187.76 | Professional | 50 · Both sides | $1,096.48 | $1,148.15 | $2,187.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $354.81 | $380.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $141.25 | $154.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $537.03 | $575.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $114.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $75.86 |
Where Pennsylvania sits
The same service costs 4.3 times more in Alaska than in Alabama. 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 $6,582AL $1,537
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.