How much rates vary
Facilitymedian $1,950 · 10th to 90th $692 to $5,495Professionalmedian $741 · 10th to 90th $646 to $1,259
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 $741.31 Median $3,235.94 Typical High $8,511.38 | Facility | None | $741.31 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $741.31 | Professional | None | $645.65 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $512.86 |
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 $707.95 Median $741.31 Typical High $1,348.96 | Professional | None | $707.95 | $741.31 | $1,348.96 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,548.82 Typical High $2,630.27 | Facility | None | $478.63 | $1,548.82 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,548.82 | Professional | None | $676.08 | $724.44 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | None | $851.14 | $1,148.15 | $1,148.15 |
Geisinger Setting Facility Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,467.37 | Facility | None | $1,584.89 | $1,995.26 | $3,467.37 |
Geisinger Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,513.56 | Professional | None | $660.69 | $891.25 | $1,513.56 |
Highmark BCBS Setting Facility Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Facility | None | $9,332.54 | $9,332.54 | $9,332.54 |
Martin's Point Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $8,317.64 | Facility | None | $741.31 | $2,818.38 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $741.31 | Professional | None | $645.65 | $660.69 | $741.31 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $512.86 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,318.26 | Professional | None | $831.76 | $1,071.52 | $1,318.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $691.83 Median $1,288.25 Typical High $2,630.27 | Facility | None | $691.83 | $1,288.25 | $2,630.27 |
UPMC Health Plan Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,000.00 | Professional | None | $691.83 | $724.44 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $5,888.44 | Facility | None | $1,148.15 | $1,905.46 | $5,888.44 |
United Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,202.26 | Professional | None | $645.65 | $776.25 | $1,202.26 |
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 $316.23 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $74.13 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,122.02 Typical High $2,041.74 | Professional | 50 · Both sides | $1,071.52 | $1,122.02 | $2,041.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $331.13 | $371.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $131.83 | $147.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $489.78 | $549.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $112.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $74.13 |
Where Pennsylvania sits
The same service costs 16.2 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
$741
AK $2,884TX $178
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.