How much rates vary
Facilitymedian $2,630 · 10th to 90th $589 to $8,318Professionalmedian $417 · 10th to 90th $380 to $661
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 $588.84 Median $3,090.30 Typical High $8,511.38 | Facility | None | $588.84 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $436.52 | Professional | None | $380.19 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $309.03 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $56,234.13 | Professional | None | $616.60 | $660.69 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,187.76 Typical High $7,762.47 | Facility | None | $478.63 | $2,187.76 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $912.01 | Professional | None | $407.38 | $416.87 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $676.08 | Professional | None | $512.86 | $676.08 | $676.08 |
Geisinger Setting Facility Modifier None Typical Low $4,677.35 Median $5,888.44 Typical High $10,232.93 | Facility | None | $4,677.35 | $5,888.44 | $10,232.93 |
Geisinger Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $912.01 | Professional | None | $398.11 | $524.81 | $912.01 |
Highmark BCBS Setting Facility Modifier None Typical Low $38,904.51 Median $38,904.51 Typical High $38,904.51 | Facility | None | $38,904.51 | $38,904.51 | $38,904.51 |
Highmark BCBS Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $549.54 | Professional | None | $426.58 | $426.58 | $549.54 |
Martin's Point Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $8,317.64 | Facility | None | $645.65 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $436.52 | Professional | None | $380.19 | $416.87 | $436.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $288.40 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $263.03 | $288.40 | $309.03 |
Oscar Health Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $831.76 | Professional | None | $549.54 | $794.33 | $831.76 |
UPMC Health Plan Setting Facility Modifier None Typical Low $416.87 Median $1,513.56 Typical High $2,951.21 | Facility | None | $416.87 | $1,513.56 | $2,951.21 |
UPMC Health Plan Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $524.81 | Professional | None | $416.87 | $524.81 | $524.81 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $741.31 | Professional | None | $398.11 | $446.68 | $741.31 |
10 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 $190.55 Median $208.93 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $75.86 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $57.54 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $41.69 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $41.69 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $204.17 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $75.86 | $83.18 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $309.03 | $331.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $57.54 | $61.66 | $66.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $40.74 | $43.65 |
Where Pennsylvania sits
The same service costs 8.3 times more in Colorado than in Montana. 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
CO $11,304MT $1,368
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.