How much rates vary
Facilitymedian $4,467 · 10th to 90th $891 to $13,490Professionalmedian $1,318 · 10th to 90th $1,175 to $2,291
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 $1,023.29 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,258.93 | $1,348.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $954.99 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,348.96 | $2,398.83 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,311.31 Typical High $14,125.38 | Facility | None | $616.60 | $3,311.31 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,288.25 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,548.82 | $2,089.30 | $2,089.30 |
Geisinger Setting Facility Modifier None Typical Low $8,709.64 Median $10,715.19 Typical High $19,054.61 | Facility | None | $8,709.64 | $10,715.19 | $19,054.61 |
Geisinger Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $2,570.40 | Professional | None | $912.01 | $1,380.38 | $2,570.40 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $4,786.30 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,786.30 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,230.27 | $1,348.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $954.99 |
Oscar Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,445.44 | $2,398.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,230.27 Median $2,137.96 Typical High $4,168.69 | Facility | None | $1,230.27 | $2,137.96 | $4,168.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | None | $1,230.27 | $1,230.27 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,715.19 | Facility | None | $1,698.24 | $3,235.94 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,412.54 | $2,089.30 |
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 $588.84 Median $630.96 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $134.90 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $1,995.26 Typical High $3,630.78 | Professional | 50 · Both sides | $1,949.84 | $1,995.26 | $3,630.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $616.60 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $616.60 | $676.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $251.19 | $269.15 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,023.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $204.17 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $134.90 |
Where Pennsylvania sits
The same service costs 7.4 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· 37th of 51
$1,349
AK $5,248TX $708
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.