How much rates vary
Facilitymedian $479 · 10th to 90th $100 to $3,802Professionalmedian $525 · 10th to 90th $457 to $832
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 $537.03 Median $2,951.21 Typical High $8,511.38 | Facility | None | $537.03 | $2,951.21 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $537.03 | Professional | None | $446.68 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $371.54 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $512.86 Median $524.81 Typical High $954.99 | Professional | None | $512.86 | $524.81 | $954.99 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $363.08 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $354.81 | $363.08 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $407.38 Typical High $794.33 | Facility | None | $144.54 | $407.38 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $912.01 | Professional | None | $457.09 | $512.86 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $954.99 | Professional | None | $707.95 | $954.99 | $954.99 |
Geisinger Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $288.40 | Facility | None | $131.83 | $165.96 | $288.40 |
Geisinger Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $1,148.15 | Professional | None | $478.63 | $676.08 | $1,148.15 |
Highmark BCBS Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | None | $489.78 | $489.78 | $537.03 |
Martin's Point Setting Facility Modifier None Typical Low $575.44 Median $2,691.53 Typical High $8,317.64 | Facility | None | $575.44 | $2,691.53 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $537.03 | Professional | None | $446.68 | $489.78 | $537.03 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $338.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $316.23 | $338.84 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $977.24 | Professional | None | $602.56 | $707.95 | $977.24 |
UPMC Health Plan Setting Facility Modifier None Typical Low $501.19 Median $1,096.48 Typical High $2,511.89 | Facility | None | $501.19 | $1,096.48 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | None | $489.78 | $537.03 | $616.60 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $812.83 | Professional | None | $457.09 | $549.54 | $812.83 |
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 $223.87 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $398.11 | Professional | 54 · Surgery only | $338.84 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $53.70 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $794.33 Typical High $1,445.44 | Professional | 50 · Both sides | $758.58 | $794.33 | $1,445.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $245.47 | $269.15 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $97.72 | $107.15 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $338.84 | $363.08 | $398.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $79.43 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $53.70 |
Where Pennsylvania sits
The same service costs 5.2 times more in Connecticut than in Florida. 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
CT $3,486FL $668
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.