How much rates vary
Facilitymedian $3,548 · 10th to 90th $871 to $8,318Professionalmedian $1,000 · 10th to 90th $871 to $1,738
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 $977.24 Median $4,897.79 Typical High $8,511.38 | Facility | None | $977.24 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,000.00 | Professional | None | $870.96 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $707.95 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,819.70 | Professional | None | $977.24 | $1,000.00 | $1,819.70 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,311.31 Typical High $5,888.44 | Facility | None | $616.60 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $2,089.30 | Professional | None | $912.01 | $977.24 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,548.82 | $1,548.82 |
Geisinger Setting Facility Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $7,943.28 | Facility | None | $3,630.78 | $4,466.84 | $7,943.28 |
Geisinger Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $2,041.74 | Professional | None | $891.25 | $1,174.90 | $2,041.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Facility | None | $7,079.46 | $7,079.46 | $7,079.46 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Martin's Point Setting Facility Modifier None Typical Low $1,000.00 Median $4,570.88 Typical High $8,511.38 | Facility | None | $1,000.00 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,000.00 | Professional | None | $870.96 | $954.99 | $1,000.00 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $707.95 |
Oscar Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,202.26 | $1,905.46 |
UPMC Health Plan Setting Facility Modifier None Typical Low $954.99 Median $2,137.96 Typical High $4,168.69 | Facility | None | $954.99 | $2,137.96 | $4,168.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,230.27 | Professional | None | $954.99 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,584.89 | Professional | None | $912.01 | $1,047.13 | $1,584.89 |
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 $436.52 Median $478.63 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $100.00 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,513.56 Typical High $2,754.23 | Professional | 50 · Both sides | $1,445.44 | $1,513.56 | $2,754.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $467.74 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $467.74 | $501.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $186.21 | $199.53 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $707.95 | $758.58 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $151.36 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $100.00 |
Where Pennsylvania sits
The same service costs 7.9 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
$1,000
AK $3,981TX $501
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.