How much rates vary
Facilitymedian $4,074 · 10th to 90th $912 to $13,490Professionalmedian $1,148 · 10th to 90th $1,000 to $1,995
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 $1,047.13 Median $3,630.78 Typical High $8,511.38 | Facility | None | $1,047.13 | $3,630.78 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,096.48 | $1,174.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $812.83 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $22,387.21 Typical High $28,183.83 | Facility | None | $3,981.07 | $22,387.21 | $28,183.83 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,174.90 | $2,137.96 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $812.83 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $776.25 | $812.83 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,311.31 Typical High $13,803.84 | Facility | None | $616.60 | $3,311.31 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,122.02 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,819.70 | $1,819.70 |
Geisinger Setting Facility Modifier None Typical Low $8,317.64 Median $10,471.29 Typical High $18,197.01 | Facility | None | $8,317.64 | $10,471.29 | $18,197.01 |
Geisinger Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,318.26 | $2,344.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $16,595.87 Typical High $33,113.11 | Facility | None | $1,778.28 | $16,595.87 | $33,113.11 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,230.27 | $1,288.25 |
Martin's Point Setting Facility Modifier None Typical Low $1,047.13 Median $3,801.89 Typical High $8,511.38 | Facility | None | $1,047.13 | $3,801.89 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,096.48 | $1,174.90 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $812.83 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,258.93 | $2,187.76 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,096.48 Median $2,137.96 Typical High $4,265.80 | Facility | None | $1,096.48 | $2,137.96 | $4,265.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,096.48 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,715.19 | Facility | None | $1,698.24 | $3,235.94 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,230.27 | $1,819.70 |
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 $501.19 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $501.19 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $117.49 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $1,737.80 Typical High $3,162.28 | Professional | 50 · Both sides | $1,698.24 | $1,737.80 | $3,162.28 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $537.03 Typical High $575.44 | Professional | 52 · Reduced service | $501.19 | $537.03 | $575.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $218.78 | $234.42 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $812.83 | $870.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $173.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $117.49 |
Where Pennsylvania sits
The same service costs 6.3 times more in Alaska than in Hawaii. 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 $20,420HI $3,232
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.