How much rates vary
Facilitymedian $2,630 · 10th to 90th $724 to $8,128Professionalmedian $1,585 · 10th to 90th $1,148 to $2,692
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 $1,380.38 Median $1,479.11 Typical High $1,584.89 | Professional | None | $1,380.38 | $1,479.11 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,023.29 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $954.99 | $1,023.29 | $1,122.02 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,584.89 | $2,951.21 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,096.48 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,096.48 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,659.59 Typical High $2,691.53 | Facility | None | $549.54 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,479.11 Typical High $3,235.94 | Professional | None | $891.25 | $1,479.11 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,778.28 | $2,398.83 | $2,398.83 |
Geisinger Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,659.59 | $2,454.71 |
Highmark BCBS Setting Facility Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $15,135.61 | Facility | None | $15,135.61 | $15,135.61 | $15,135.61 |
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 $1,380.38 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,380.38 | $1,412.54 | $1,584.89 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,288.25 | $1,862.09 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,148.15 Median $2,187.76 Typical High $3,715.35 | Facility | None | $1,148.15 | $2,187.76 | $3,715.35 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,148.15 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $7,079.46 | Facility | None | $1,698.24 | $3,235.94 | $7,079.46 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,621.81 Typical High $2,454.71 | Professional | None | $933.25 | $1,621.81 | $2,454.71 |
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 $691.83 Median $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $295.12 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,096.48 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,023.29 | $1,096.48 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $158.49 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,398.83 Typical High $4,466.84 | Professional | 50 · Both sides | $2,290.87 | $2,398.83 | $4,466.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $707.95 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $281.84 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,202.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $213.80 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $213.80 | $239.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $141.25 | $158.49 |
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· 40th of 51
$1,585
AK $6,166TX $724
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.