How much rates vary
Facilitymedian $832 · 10th to 90th $282 to $3,890Professionalmedian $257 · 10th to 90th $162 to $437
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 $288.40 Median $2,137.96 Typical High $8,317.64 | Facility | None | $288.40 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $288.40 | Professional | None | $154.88 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $109.65 | $165.96 | $199.53 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,630.27 Median $2,818.38 Typical High $8,709.64 | Facility | None | $2,630.27 | $2,818.38 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $501.19 | Professional | None | $269.15 | $275.42 | $501.19 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $218.78 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $213.80 | $218.78 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $724.44 Typical High $1,412.54 | Facility | None | $338.84 | $724.44 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $398.11 | Professional | None | $162.18 | $239.88 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $467.74 | Professional | None | $354.81 | $467.74 | $467.74 |
Geisinger Setting Facility Modifier None Typical Low $724.44 Median $891.25 Typical High $1,584.89 | Facility | None | $724.44 | $891.25 | $1,584.89 |
Geisinger Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $524.81 | Professional | None | $213.80 | $309.03 | $524.81 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $7,244.36 | Facility | None | $478.63 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $288.40 | Professional | None | $154.88 | $245.47 | $288.40 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $162.18 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $109.65 | $162.18 | $199.53 |
Oscar Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $524.81 | Professional | None | $309.03 | $309.03 | $524.81 |
UPMC Health Plan Setting Facility Modifier None Typical Low $208.93 Median $812.83 Typical High $1,862.09 | Facility | None | $208.93 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $281.84 | Professional | None | $169.82 | $263.03 | $281.84 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $3,467.37 | Facility | None | $199.53 | $436.52 | $3,467.37 |
United Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $363.08 | Professional | None | $173.78 | $251.19 | $363.08 |
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 $77.62 Median $117.49 Typical High $144.54 | Professional | 52 · Reduced service | $77.62 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $46.77 Typical High $57.54 | Professional | 53 · Discontinued | $30.90 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $117.49 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $35.48 Typical High $43.65 | Professional | 55 · Aftercare only | $23.44 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $23.44 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.49 | $23.44 | $28.84 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $416.87 Typical High $758.58 | Professional | 50 · Both sides | $398.11 | $416.87 | $758.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $117.49 Typical High $144.54 | Professional | 52 · Reduced service | $77.62 | $117.49 | $144.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $46.77 Typical High $57.54 | Professional | 53 · Discontinued | $30.90 | $46.77 | $57.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $173.78 Typical High $213.80 | Professional | 54 · Surgery only | $117.49 | $173.78 | $213.80 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $35.48 Typical High $43.65 | Professional | 55 · Aftercare only | $23.44 | $35.48 | $43.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $23.44 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.49 | $23.44 | $28.84 |
Where Pennsylvania sits
The same service costs 4.1 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· 37th of 51
$263
AK $851TX $209
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.