How much rates vary
Facilitymedian $3,890 · 10th to 90th $851 to $10,965Professionalmedian $851 · 10th to 90th $741 to $1,479
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 $851.14 Median $5,495.41 Typical High $8,709.64 | Facility | None | $851.14 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $851.14 | Professional | None | $741.31 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $602.56 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $10,715.19 Typical High $12,022.64 | Facility | None | $3,981.07 | $10,715.19 | $12,022.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,584.89 | Professional | None | $831.76 | $870.96 | $1,584.89 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $588.84 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $575.44 | $588.84 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,801.89 Typical High $10,964.78 | Facility | None | $707.95 | $3,801.89 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,778.28 | Professional | None | $741.31 | $831.76 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,318.26 | Professional | None | $977.24 | $1,318.26 | $1,318.26 |
Geisinger Setting Facility Modifier None Typical Low $6,606.93 Median $8,317.64 Typical High $14,454.40 | Facility | None | $6,606.93 | $8,317.64 | $14,454.40 |
Geisinger Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,621.81 | Professional | None | $741.31 | $954.99 | $1,621.81 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $4,897.79 Typical High $8,709.64 | Facility | None | $912.01 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $851.14 | Professional | None | $741.31 | $812.83 | $851.14 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,584.89 | Professional | None | $954.99 | $1,000.00 | $1,584.89 |
UPMC Health Plan Setting Facility Modifier None Typical Low $812.83 Median $2,570.40 Typical High $5,011.87 | Facility | None | $812.83 | $2,570.40 | $5,011.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | None | $812.83 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,454.71 Typical High $13,182.57 | Facility | None | $1,380.38 | $2,454.71 | $13,182.57 |
United Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,348.96 | Professional | None | $758.58 | $891.25 | $1,348.96 |
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 $371.54 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $85.11 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,288.25 Typical High $2,344.23 | Professional | 50 · Both sides | $1,258.93 | $1,288.25 | $2,344.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $398.11 | $426.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $162.18 | $169.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $602.56 | $645.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $85.11 |
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
$851
AK $3,388TX $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.