How much rates vary
Facilitymedian $2,630 · 10th to 90th $692 to $8,128Professionalmedian $1,072 · 10th to 90th $933 to $1,862
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 $1,023.29 Median $5,495.41 Typical High $8,709.64 | Facility | None | $1,023.29 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,071.52 | Professional | None | $933.25 | $1,000.00 | $1,071.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $758.58 |
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 $1,047.13 Median $1,071.52 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,071.52 | $1,995.26 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $1,380.38 |
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 $977.24 Median $1,047.13 Typical High $2,238.72 | Professional | None | $977.24 | $1,047.13 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,659.59 | $1,659.59 |
Geisinger Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $2,187.76 | Professional | None | $954.99 | $1,258.93 | $2,187.76 |
Martin's Point Setting Facility Modifier None Typical Low $1,071.52 Median $5,248.07 Typical High $8,709.64 | Facility | None | $1,071.52 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,071.52 | Professional | None | $933.25 | $977.24 | $1,071.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $758.58 |
Oscar Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,230.27 | $1,949.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,023.29 | $1,071.52 | $1,071.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,023.29 | $1,071.52 | $1,071.52 |
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 $1,122.02 Typical High $1,698.24 | Professional | None | $933.25 | $1,122.02 | $1,698.24 |
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 $467.74 Median $489.78 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $213.80 | Professional | 53 · Discontinued | $186.21 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $107.15 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,621.81 Typical High $2,951.21 | Professional | 50 · Both sides | $1,548.82 | $1,621.81 | $2,951.21 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $478.63 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $478.63 | $537.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $213.80 | Professional | 53 · Discontinued | $186.21 | $194.98 | $213.80 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $724.44 | $812.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $162.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $107.15 |
Where Pennsylvania sits
The same service costs 18.2 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
$1,072
AK $4,266TX $234
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.