How much rates vary
Facilitymedian $3,631 · 10th to 90th $692 to $14,454Professionalmedian $1,122 · 10th to 90th $1,000 to $2,042
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 $1,000.00 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,000.00 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,122.02 | Professional | None | $977.24 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $676.08 | $741.31 | $776.25 |
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 $1,071.52 Median $1,122.02 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,122.02 | $2,041.74 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $8,912.51 Typical High $15,488.17 | Facility | None | $501.19 | $8,912.51 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,096.48 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,737.80 | $2,344.23 | $2,344.23 |
Geisinger Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,548.82 | $2,398.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $56,234.13 Median $56,234.13 Typical High $56,234.13 | Facility | None | $56,234.13 | $56,234.13 | $56,234.13 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $4,786.30 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,786.30 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,122.02 | Professional | None | $977.24 | $1,047.13 | $1,122.02 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $724.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $776.25 |
Oscar Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,348.96 | $2,137.96 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,047.13 Median $2,187.76 Typical High $3,715.35 | Facility | None | $1,047.13 | $2,187.76 | $3,715.35 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,047.13 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,715.19 | Facility | None | $1,698.24 | $3,235.94 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,174.90 | $1,819.70 |
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 $478.63 Median $524.81 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $194.98 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $724.44 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $104.71 Typical High $112.20 | Professional | 56 · Pre-op care only | $97.72 | $104.71 | $112.20 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,659.59 Typical High $3,090.30 | Professional | 50 · Both sides | $1,621.81 | $1,659.59 | $3,090.30 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $524.81 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $524.81 | $562.34 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $194.98 | $208.93 | $223.87 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $776.25 Typical High $831.76 | Professional | 54 · Surgery only | $724.44 | $776.25 | $831.76 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $165.96 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $104.71 Typical High $112.20 | Professional | 56 · Pre-op care only | $97.72 | $104.71 | $112.20 |
Where Pennsylvania sits
The same service costs 6.0 times more in Alaska than in Kentucky. 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
AK $15,585KY $2,601
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.