How much rates vary
Facilitymedian $1,445 · 10th to 90th $513 to $5,888Professionalmedian $468 · 10th to 90th $324 to $776
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 $416.87 Median $1,348.96 Typical High $7,244.36 | Facility | None | $416.87 | $1,348.96 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $512.86 | Professional | None | $309.03 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $234.42 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $302.00 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $218.78 | $302.00 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $457.09 | Professional | None | $309.03 | $309.03 | $457.09 |
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 $467.74 Median $478.63 Typical High $1,000.00 | Professional | None | $467.74 | $478.63 | $1,000.00 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $331.13 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $316.23 | $331.13 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,202.26 Typical High $2,041.74 | Facility | None | $501.19 | $1,202.26 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $758.58 | Professional | None | $331.13 | $457.09 | $758.58 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $812.83 | Professional | None | $616.60 | $812.83 | $812.83 |
Geisinger Setting Facility Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,630.27 | Facility | None | $1,202.26 | $1,513.56 | $2,630.27 |
Geisinger Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $933.25 | Professional | None | $323.59 | $501.19 | $933.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $5,011.87 Typical High $9,772.37 | Facility | None | $1,380.38 | $5,011.87 | $9,772.37 |
Highmark BCBS Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $478.63 | Professional | None | $323.59 | $346.74 | $478.63 |
Martin's Point Setting Facility Modifier None Typical Low $467.74 Median $1,584.89 Typical High $7,079.46 | Facility | None | $467.74 | $1,584.89 | $7,079.46 |
Martin's Point Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $512.86 | Professional | None | $309.03 | $436.52 | $512.86 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $234.42 | $323.59 | $380.19 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $302.00 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $218.78 | $302.00 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $660.69 | Professional | None | $562.34 | $575.44 | $660.69 |
UPMC Health Plan Setting Facility Modifier None Typical Low $323.59 Median $1,202.26 Typical High $3,311.31 | Facility | None | $323.59 | $1,202.26 | $3,311.31 |
UPMC Health Plan Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $467.74 | Professional | None | $323.59 | $457.09 | $467.74 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,265.80 | Facility | None | $812.83 | $1,318.26 | $4,265.80 |
United Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $691.83 | Professional | None | $338.84 | $478.63 | $691.83 |
1 more rate 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 |
|---|---|---|---|---|---|
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $724.44 Typical High $1,479.11 | Professional | 50 · Both sides | $691.83 | $724.44 | $1,479.11 |
Where Pennsylvania sits
The same service costs 6.0 times more in Colorado than in West Virginia. 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
CO $6,136WV $1,026
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.