How much rates vary
Facilitymedian $372 · 10th to 90th $102 to $2,754Professionalmedian $316 · 10th to 90th $263 to $525
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 $331.13 Median $1,000.00 Typical High $6,606.93 | Facility | None | $331.13 | $1,000.00 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $398.11 | Professional | None | $263.03 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $204.17 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $181.97 | $204.17 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
AmeriHealth Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $338.84 | Professional | None | $269.15 | $338.84 | $338.84 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $660.69 | Professional | None | $323.59 | $446.68 | $660.69 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $309.03 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $223.87 | $309.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $323.59 Typical High $562.34 | Facility | None | $144.54 | $323.59 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $549.54 | Professional | None | $251.19 | $302.00 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $602.56 | Professional | None | $446.68 | $602.56 | $602.56 |
Geisinger Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $288.40 | Facility | None | $131.83 | $165.96 | $288.40 |
Geisinger Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $630.96 | Professional | None | $218.78 | $346.74 | $630.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $1,445.44 | Facility | None | $295.12 | $1,023.29 | $1,445.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $416.87 | Professional | None | $309.03 | $346.74 | $416.87 |
Independence Blue Cross Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $338.84 | Professional | None | $269.15 | $338.84 | $338.84 |
Martin's Point Setting Facility Modifier None Typical Low $331.13 Median $1,348.96 Typical High $6,606.93 | Facility | None | $331.13 | $1,348.96 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $380.19 | Professional | None | $263.03 | $302.00 | $380.19 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $204.17 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $181.97 | $204.17 | $234.42 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $588.84 | Professional | None | $346.74 | $346.74 | $588.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $309.03 Median $812.83 Typical High $1,862.09 | Facility | None | $309.03 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $338.84 | Professional | None | $288.40 | $309.03 | $338.84 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $489.78 | Professional | None | $263.03 | $331.13 | $489.78 |
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 $131.83 Median $147.91 Typical High $165.96 | Professional | 52 · Reduced service | $131.83 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $66.07 | Professional | 53 · Discontinued | $52.48 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $218.78 Typical High $251.19 | Professional | 54 · Surgery only | $194.98 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $43.65 Typical High $50.12 | Professional | 55 · Aftercare only | $38.90 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $33.11 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $676.08 Typical High $977.24 | Professional | 50 · Both sides | $478.63 | $676.08 | $977.24 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $147.91 Typical High $165.96 | Professional | 52 · Reduced service | $131.83 | $147.91 | $165.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $66.07 | Professional | 53 · Discontinued | $52.48 | $58.88 | $66.07 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $218.78 Typical High $251.19 | Professional | 54 · Surgery only | $194.98 | $218.78 | $251.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $43.65 Typical High $50.12 | Professional | 55 · Aftercare only | $38.90 | $43.65 | $50.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $33.11 |
Where Pennsylvania sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$316
AK $1,202UT $219
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.