How much rates vary
Facilitymedian $417 · 10th to 90th $102 to $2,818Professionalmedian $427 · 10th to 90th $363 to $692
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 $407.38 Median $1,584.89 Typical High $7,244.36 | Facility | None | $407.38 | $1,584.89 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $446.68 | Professional | None | $346.74 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $436.52 Median $446.68 Typical High $794.33 | Professional | None | $436.52 | $446.68 | $794.33 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $309.03 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $302.00 | $309.03 | $549.54 |
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 $363.08 Median $416.87 Typical High $724.44 | Professional | None | $363.08 | $416.87 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $870.96 | Professional | None | $645.65 | $870.96 | $870.96 |
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 $309.03 Median $489.78 Typical High $870.96 | Professional | None | $309.03 | $489.78 | $870.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $389.05 Median $776.25 Typical High $1,318.26 | Facility | None | $389.05 | $776.25 | $1,318.26 |
Highmark BCBS Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $512.86 | Professional | None | $407.38 | $467.74 | $512.86 |
Martin's Point Setting Facility Modifier None Typical Low $407.38 Median $1,513.56 Typical High $6,606.93 | Facility | None | $407.38 | $1,513.56 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $446.68 | Professional | None | $346.74 | $398.11 | $446.68 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $316.23 |
Oscar Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $812.83 | Professional | None | $478.63 | $478.63 | $812.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $416.87 Median $812.83 Typical High $1,862.09 | Facility | None | $416.87 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $489.78 | Professional | None | $380.19 | $426.58 | $489.78 |
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 $363.08 Median $446.68 Typical High $676.08 | Professional | None | $363.08 | $446.68 | $676.08 |
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 $173.78 Median $199.53 Typical High $223.87 | Professional | 52 · Reduced service | $173.78 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $79.43 Typical High $89.13 | Professional | 53 · Discontinued | $69.18 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $338.84 | Professional | 54 · Surgery only | $263.03 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $60.26 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $44.67 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $44.67 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $676.08 Typical High $1,174.90 | Professional | 50 · Both sides | $645.65 | $676.08 | $1,174.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $199.53 Typical High $223.87 | Professional | 52 · Reduced service | $173.78 | $199.53 | $223.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $79.43 Typical High $89.13 | Professional | 53 · Discontinued | $69.18 | $79.43 | $89.13 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $338.84 | Professional | 54 · Surgery only | $263.03 | $295.12 | $338.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $60.26 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $60.26 | $67.61 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $44.67 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $44.67 |
Where Pennsylvania sits
The same service costs 5.6 times more in Connecticut than in Florida. 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
CT $3,322FL $590
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.