How much rates vary
Facilitymedian $2,291 · 10th to 90th $692 to $7,244Professionalmedian $1,585 · 10th to 90th $1,380 to $2,754
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 $1,023.29 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,380.38 | $1,513.56 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,122.02 |
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 $1,548.82 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,621.81 | $2,951.21 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,096.48 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,096.48 | $2,041.74 |
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 $1,479.11 Median $1,548.82 Typical High $3,311.31 | Professional | None | $1,479.11 | $1,548.82 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,778.28 | $2,454.71 | $2,454.71 |
Geisinger Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,412.54 | $1,862.09 | $3,311.31 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,380.38 | $1,513.56 | $1,584.89 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,778.28 | $1,862.09 | $3,090.30 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,513.56 | $1,621.81 | $1,621.81 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,513.56 | $1,621.81 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $5,888.44 | Facility | None | $1,148.15 | $1,905.46 | $5,888.44 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,698.24 | $2,511.89 |
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 $691.83 Median $758.58 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $158.49 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $2,398.83 Typical High $4,466.84 | Professional | 50 · Both sides | $2,344.23 | $2,398.83 | $4,466.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $741.31 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $302.00 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,202.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $239.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $158.49 |
Where Pennsylvania sits
The same service costs 16.2 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
$1,585
AK $6,310TX $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.