How much rates vary
Facilitymedian $2,884 · 10th to 90th $708 to $8,710Professionalmedian $1,230 · 10th to 90th $1,072 to $2,291
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 $1,047.13 Median $5,495.41 Typical High $8,709.64 | Facility | None | $1,047.13 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,071.52 | $1,174.90 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $870.96 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $22,387.21 Typical High $28,183.83 | Facility | None | $3,981.07 | $22,387.21 | $28,183.83 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,230.27 | $2,344.23 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,365.16 Typical High $7,585.78 | Facility | None | $549.54 | $4,365.16 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,202.26 | $2,630.27 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,862.09 | $1,862.09 |
Geisinger Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,445.44 | $2,630.27 |
Martin's Point Setting Facility Modifier None Typical Low $1,148.15 Median $5,248.07 Typical High $8,709.64 | Facility | None | $1,148.15 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,071.52 | $1,174.90 | $1,230.27 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $870.96 |
Oscar Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,548.82 | $2,454.71 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,174.90 | $1,412.54 | $1,412.54 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,174.90 | $1,412.54 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,318.26 | $1,949.84 |
12 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 $537.03 Median $588.84 Typical High $616.60 | Professional | 52 · Reduced service | $537.03 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $234.42 Typical High $245.47 | Professional | 53 · Discontinued | $213.80 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $117.49 Typical High $123.03 | Professional | 56 · Pre-op care only | $107.15 | $117.49 | $123.03 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $1,862.09 Typical High $3,548.13 | Professional | 50 · Both sides | $1,778.28 | $1,862.09 | $3,548.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $575.44 Typical High $616.60 | Professional | 52 · Reduced service | $537.03 | $575.44 | $616.60 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $245.47 | Professional | 53 · Discontinued | $213.80 | $229.09 | $245.47 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $870.96 | $933.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $186.21 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $123.03 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $123.03 |
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 62 · Two surgeons | $1,288.25 | $1,288.25 | $1,288.25 |
Where Pennsylvania sits
The same service costs 8.7 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· 42nd of 51
$1,230
AK $4,786TX $550
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.