How much rates vary
Facilitymedian $3,388 · 10th to 90th $692 to $6,761Professionalmedian $724 · 10th to 90th $631 to $1,318
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 $724.44 Median $3,890.45 Typical High $8,317.64 | Facility | None | $724.44 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $724.44 | Professional | None | $630.96 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $512.86 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,318.26 | Professional | None | $707.95 | $741.31 | $1,318.26 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,691.53 Typical High $5,888.44 | Facility | None | $524.81 | $2,691.53 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,548.82 | Professional | None | $630.96 | $707.95 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | None | $851.14 | $1,148.15 | $1,148.15 |
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 $630.96 Median $831.76 Typical High $1,412.54 | Professional | None | $630.96 | $831.76 | $1,412.54 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $724.44 | Professional | None | $630.96 | $676.08 | $724.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $512.86 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,288.25 | Professional | None | $831.76 | $831.76 | $1,288.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $691.83 Median $2,754.23 Typical High $4,677.35 | Facility | None | $691.83 | $2,754.23 | $4,677.35 |
UPMC Health Plan Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $630.96 Median $758.58 Typical High $1,148.15 | Professional | None | $630.96 | $758.58 | $1,148.15 |
13 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 $316.23 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $72.44 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,096.48 Typical High $1,995.26 | Professional | 50 · Both sides | $1,071.52 | $1,096.48 | $1,995.26 |
Highmark BCBS Setting Professional Modifier 58 · Staged procedure Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 58 · Staged procedure | $1,122.02 | $1,122.02 | $1,122.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $331.13 | $363.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $134.90 | $147.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $501.19 | $549.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $109.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $67.61 | $72.44 |
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 62 · Two surgeons | $691.83 | $691.83 | $691.83 |
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· 41st of 51
$724
AK $2,884TX $363
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.