How much rates vary
Facilitymedian $3,467 · 10th to 90th $692 to $7,762Professionalmedian $692 · 10th to 90th $603 to $1,175
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 $812.83 Median $4,897.79 Typical High $8,511.38 | Facility | None | $812.83 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $691.83 | Professional | None | $602.56 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $416.87 | $457.09 | $489.78 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $1,258.93 | Professional | None | $676.08 | $691.83 | $1,258.93 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $478.63 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $467.74 | $478.63 | $870.96 |
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 $616.60 Median $676.08 Typical High $1,445.44 | Professional | None | $616.60 | $676.08 | $1,445.44 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,096.48 | Professional | None | $794.33 | $1,096.48 | $1,096.48 |
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 $616.60 Median $812.83 Typical High $1,412.54 | Professional | None | $616.60 | $812.83 | $1,412.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $25,118.86 | Facility | None | $4,168.69 | $4,168.69 | $25,118.86 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $4,570.88 Typical High $8,511.38 | Facility | None | $831.76 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $691.83 | Professional | None | $602.56 | $645.65 | $691.83 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $416.87 | $457.09 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,288.25 | Professional | None | $776.25 | $831.76 | $1,288.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $645.65 Median $2,454.71 Typical High $4,265.80 | Facility | None | $645.65 | $2,454.71 | $4,265.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | None | $645.65 | $724.44 | $724.44 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,071.52 | Professional | None | $616.60 | $724.44 | $1,071.52 |
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 $302.00 Median $323.59 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $120.23 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $489.78 Typical High $524.81 | Professional | 54 · Surgery only | $446.68 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $104.71 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $64.57 Typical High $69.18 | Professional | 56 · Pre-op care only | $60.26 | $64.57 | $69.18 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,047.13 Typical High $1,905.46 | Professional | 50 · Both sides | $1,000.00 | $1,047.13 | $1,905.46 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $323.59 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $323.59 | $346.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $138.04 | Professional | 53 · Discontinued | $120.23 | $128.82 | $138.04 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $489.78 Typical High $524.81 | Professional | 54 · Surgery only | $446.68 | $489.78 | $524.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $104.71 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $104.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $64.57 Typical High $69.18 | Professional | 56 · Pre-op care only | $60.26 | $64.57 | $69.18 |
Where Pennsylvania sits
The same service costs 8.1 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· 43rd of 51
$692
AK $2,754TX $339
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.