How much rates vary
Facilitymedian $347 · 10th to 90th $100 to $2,818Professionalmedian $324 · 10th to 90th $275 to $550
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 $346.74 Median $1,995.26 Typical High $7,943.28 | Facility | None | $346.74 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $371.54 | Professional | None | $275.42 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $213.80 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $190.55 | $213.80 | $239.88 |
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 $338.84 Median $346.74 Typical High $602.56 | Professional | None | $338.84 | $346.74 | $602.56 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $239.88 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $229.09 | $239.88 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $323.59 Typical High $562.34 | Facility | None | $144.54 | $323.59 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $575.44 | Professional | None | $257.04 | $316.23 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $645.65 | Professional | None | $478.63 | $645.65 | $645.65 |
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 $288.40 Median $416.87 Typical High $676.08 | Professional | None | $288.40 | $416.87 | $676.08 |
Highmark BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,862.09 | Facility | None | $691.83 | $1,047.13 | $1,862.09 |
Highmark BCBS Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $398.11 | Professional | None | $323.59 | $346.74 | $398.11 |
Martin's Point Setting Facility Modifier None Typical Low $346.74 Median $1,995.26 Typical High $7,244.36 | Facility | None | $346.74 | $1,995.26 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $346.74 | Professional | None | $275.42 | $309.03 | $346.74 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $213.80 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $190.55 | $213.80 | $239.88 |
Oscar Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $602.56 | Professional | None | $363.08 | $363.08 | $602.56 |
UPMC Health Plan Setting Facility Modifier None Typical Low $251.19 Median $812.83 Typical High $1,862.09 | Facility | None | $251.19 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $323.59 | Professional | None | $251.19 | $309.03 | $323.59 |
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 $263.03 Median $338.84 Typical High $512.86 | Professional | None | $263.03 | $338.84 | $512.86 |
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 $134.90 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $134.90 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $69.18 | Professional | 53 · Discontinued | $54.95 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $257.04 | Professional | 54 · Surgery only | $204.17 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $51.29 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $34.67 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $524.81 Typical High $912.01 | Professional | 50 · Both sides | $501.19 | $524.81 | $912.01 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $134.90 | $151.36 | $173.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $69.18 | Professional | 53 · Discontinued | $54.95 | $60.26 | $69.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $257.04 | Professional | 54 · Surgery only | $204.17 | $229.09 | $257.04 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $51.29 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $51.29 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $34.67 |
Where Pennsylvania sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$324
AK $1,259UT $219
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.