How much rates vary
Facilitymedian $3,802 · 10th to 90th $724 to $8,511Professionalmedian $1,698 · 10th to 90th $1,479 to $2,951
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 $891.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $891.25 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,479.11 | $1,621.81 | $1,698.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,122.02 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,122.02 | $1,202.26 |
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 $1,659.59 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,659.59 | $1,698.24 | $3,162.28 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $5,888.44 | Facility | None | $501.19 | $2,691.53 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $3,467.37 | Professional | None | $1,584.89 | $1,659.59 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,905.46 | $2,570.40 | $2,570.40 |
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 $1,513.56 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,905.46 | $3,388.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $12,589.25 Typical High $19,952.62 | Facility | None | $6,025.60 | $12,589.25 | $19,952.62 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,089.30 | $2,884.03 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $3,630.78 Typical High $8,317.64 | Facility | None | $954.99 | $3,630.78 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,479.11 | $1,621.81 | $1,698.24 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,122.02 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,122.02 | $1,202.26 |
Oscar Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,778.28 | $1,778.28 | $3,311.31 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,548.82 Median $5,754.40 Typical High $9,120.11 | Facility | None | $1,548.82 | $5,754.40 | $9,120.11 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,548.82 | $1,548.82 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,000.00 | Facility | None | $1,698.24 | $3,235.94 | $10,000.00 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,548.82 | $1,819.70 | $2,691.53 |
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 $741.31 Median $812.83 Typical High $851.14 | Professional | 52 · Reduced service | $741.31 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $323.59 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,202.26 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,122.02 | $1,202.26 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $223.87 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $162.18 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $162.18 | $169.82 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $2,570.40 Typical High $4,786.30 | Professional | 50 · Both sides | $2,454.71 | $2,570.40 | $4,786.30 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $794.33 Typical High $851.14 | Professional | 52 · Reduced service | $741.31 | $794.33 | $851.14 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $316.23 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $316.23 | $338.84 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,202.26 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,122.02 | $1,202.26 | $1,288.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $223.87 | $239.88 | $257.04 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $158.49 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $158.49 | $169.82 |
Where Pennsylvania sits
The same service costs 7.8 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
$1,698
AK $6,761TX $871
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.