How much rates vary
Facilitymedian $891 · 10th to 90th $98 to $3,890Professionalmedian $708 · 10th to 90th $617 to $1,230
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 $2,344.23 Typical High $8,317.64 | Facility | None | $724.44 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $724.44 | Professional | None | $616.60 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $501.19 |
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 $691.83 Median $724.44 Typical High $1,288.25 | Professional | None | $691.83 | $724.44 | $1,288.25 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $812.83 Typical High $1,445.44 | Facility | None | $338.84 | $812.83 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,513.56 | Professional | None | $630.96 | $691.83 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
Geisinger Setting Facility Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,862.09 | Facility | None | $851.14 | $1,047.13 | $1,862.09 |
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 $724.44 Median $2,344.23 Typical High $7,244.36 | Facility | None | $724.44 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $724.44 | Professional | None | $616.60 | $676.08 | $724.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,318.26 | Professional | None | $812.83 | $851.14 | $1,318.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $676.08 Median $977.24 Typical High $1,949.84 | Facility | None | $676.08 | $977.24 | $1,949.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $707.95 | Professional | None | $676.08 | $691.83 | $707.95 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $3,388.44 | Facility | None | $77.62 | $158.49 | $3,388.44 |
United Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,122.02 | Professional | None | $630.96 | $741.31 | $1,122.02 |
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 $309.03 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $72.44 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,096.48 Typical High $1,949.84 | Professional | 50 · Both sides | $1,047.13 | $1,096.48 | $1,949.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $338.84 | $363.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $134.90 | $144.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $501.19 | $537.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $107.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $72.44 |
Where Pennsylvania sits
The same service costs 8.5 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· 39th of 51
$708
AK $2,818TX $331
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.