How much rates vary
Facilitymedian $1,778 · 10th to 90th $617 to $6,166Professionalmedian $407 · 10th to 90th $269 to $661
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 $436.52 Median $4,570.88 Typical High $8,511.38 | Facility | None | $436.52 | $4,570.88 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $436.52 | Professional | None | $251.19 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $263.03 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $173.78 | $263.03 | $302.00 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,981.07 | $6,025.60 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $912.01 | Professional | None | $407.38 | $426.58 | $912.01 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $295.12 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $281.84 | $295.12 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,584.89 Typical High $2,818.38 | Facility | None | $616.60 | $1,584.89 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $645.65 | Professional | None | $269.15 | $398.11 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | None | $537.03 | $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 $281.84 Median $436.52 Typical High $831.76 | Professional | None | $281.84 | $436.52 | $831.76 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $18,620.87 | Facility | None | $3,801.89 | $4,466.84 | $18,620.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $489.78 | Professional | None | $331.13 | $331.13 | $489.78 |
Martin's Point Setting Facility Modifier None Typical Low $537.03 Median $4,265.80 Typical High $8,511.38 | Facility | None | $537.03 | $4,265.80 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $436.52 | Professional | None | $251.19 | $371.54 | $436.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $251.19 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $173.78 | $251.19 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $933.25 | Professional | None | $489.78 | $676.08 | $933.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $338.84 Median $1,513.56 Typical High $3,548.13 | Facility | None | $338.84 | $1,513.56 | $3,548.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $426.58 | Professional | None | $269.15 | $398.11 | $426.58 |
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 $281.84 Median $426.58 Typical High $588.84 | Professional | None | $281.84 | $426.58 | $588.84 |
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 $125.89 Median $186.21 Typical High $213.80 | Professional | 52 · Reduced service | $125.89 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $74.13 Typical High $87.10 | Professional | 53 · Discontinued | $50.12 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $281.84 Typical High $323.59 | Professional | 54 · Surgery only | $186.21 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $56.23 Typical High $64.57 | Professional | 55 · Aftercare only | $37.15 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $37.15 Typical High $43.65 | Professional | 56 · Pre-op care only | $25.12 | $37.15 | $43.65 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $630.96 Typical High $1,348.96 | Professional | 50 · Both sides | $616.60 | $630.96 | $1,348.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $125.89 | $181.97 | $213.80 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $72.44 Typical High $87.10 | Professional | 53 · Discontinued | $50.12 | $72.44 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $186.21 | $269.15 | $323.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $37.15 | $54.95 | $64.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $36.31 Typical High $43.65 | Professional | 56 · Pre-op care only | $25.12 | $36.31 | $43.65 |
Where Pennsylvania sits
The same service costs 5.9 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· 38th of 51
$407
AK $1,413UT $240
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.