How much rates vary
Facilitymedian $1,778 · 10th to 90th $537 to $5,495Professionalmedian $355 · 10th to 90th $229 to $575
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 $380.19 Median $3,090.30 Typical High $8,511.38 | Facility | None | $380.19 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $380.19 | Professional | None | $208.93 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $229.09 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $147.91 | $229.09 | $263.03 |
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 $354.81 Median $371.54 Typical High $741.31 | Professional | None | $354.81 | $371.54 | $741.31 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $257.04 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $245.47 | $257.04 | $512.86 |
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 $229.09 Median $346.74 Typical High $537.03 | Professional | None | $229.09 | $346.74 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $602.56 | Professional | None | $467.74 | $602.56 | $602.56 |
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 $229.09 Median $371.54 Typical High $707.95 | Professional | None | $229.09 | $371.54 | $707.95 |
Highmark BCBS Setting Facility Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Facility | None | $11,220.18 | $11,220.18 | $11,220.18 |
Martin's Point Setting Facility Modifier None Typical Low $575.44 Median $2,754.23 Typical High $8,317.64 | Facility | None | $575.44 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $380.19 | Professional | None | $208.93 | $323.59 | $380.19 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $223.87 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $147.91 | $223.87 | $263.03 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $776.25 | Professional | None | $416.87 | $436.52 | $776.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $331.13 Median $1,096.48 Typical High $2,511.89 | Facility | None | $331.13 | $1,096.48 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $407.38 | Professional | None | $229.09 | $354.81 | $407.38 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,466.84 | Facility | None | $812.83 | $1,318.26 | $4,466.84 |
United Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $489.78 | Professional | None | $234.42 | $354.81 | $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 $104.71 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $104.71 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $64.57 Typical High $75.86 | Professional | 53 · Discontinued | $41.69 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $245.47 Typical High $281.84 | Professional | 54 · Surgery only | $158.49 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $31.62 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $20.89 | $32.36 | $38.02 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $549.54 Typical High $1,096.48 | Professional | 50 · Both sides | $537.03 | $549.54 | $1,096.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $104.71 | $158.49 | $190.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $41.69 | $63.10 | $75.86 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $239.88 Typical High $281.84 | Professional | 54 · Surgery only | $158.49 | $239.88 | $281.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $31.62 | $47.86 | $57.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $20.89 | $31.62 | $38.02 |
Where Pennsylvania sits
The same service costs 5.5 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· 36th of 51
$355
AK $1,202TX $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.