How much rates vary
Facilitymedian $1,549 · 10th to 90th $324 to $5,129Professionalmedian $417 · 10th to 90th $372 to $741
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 $537.03 Median $2,454.71 Typical High $8,317.64 | Facility | None | $537.03 | $2,454.71 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $426.58 | Professional | None | $371.54 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $281.84 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $257.04 | $281.84 | $302.00 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $741.31 | Professional | None | $416.87 | $436.52 | $741.31 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,513.56 Typical High $2,630.27 | Facility | None | $338.84 | $1,513.56 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $891.25 | Professional | None | $354.81 | $398.11 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $691.83 | Professional | None | $512.86 | $691.83 | $691.83 |
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 $380.19 Median $501.19 Typical High $831.76 | Professional | None | $380.19 | $501.19 | $831.76 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $8,128.31 | Facility | None | $588.84 | $2,344.23 | $8,128.31 |
Martin's Point Setting Professional Modifier None Typical Low $371.54 Median $380.19 Typical High $426.58 | Professional | None | $371.54 | $380.19 | $426.58 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $269.15 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $257.04 | $269.15 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $741.31 | Professional | None | $436.52 | $436.52 | $741.31 |
UPMC Health Plan Setting Facility Modifier None Typical Low $380.19 Median $1,122.02 Typical High $2,238.72 | Facility | None | $380.19 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $407.38 | Professional | None | $380.19 | $380.19 | $407.38 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $3,890.45 | Facility | None | $199.53 | $436.52 | $3,890.45 |
United Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $660.69 | Professional | None | $354.81 | $436.52 | $660.69 |
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 $186.21 Median $199.53 Typical High $213.80 | Professional | 52 · Reduced service | $186.21 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $74.13 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $275.42 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $39.81 Typical High $42.66 | Professional | 56 · Pre-op care only | $37.15 | $39.81 | $42.66 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $645.65 Typical High $1,122.02 | Professional | 50 · Both sides | $630.96 | $645.65 | $1,122.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $190.55 Typical High $213.80 | Professional | 52 · Reduced service | $186.21 | $190.55 | $213.80 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $74.13 | $75.86 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $288.40 Typical High $323.59 | Professional | 54 · Surgery only | $275.42 | $288.40 | $323.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $54.95 | $57.54 | $64.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $37.15 | $38.02 | $42.66 |
Where Pennsylvania sits
The same service costs 8.1 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
$427
AK $1,698TX $209
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.