How much rates vary
Facilitymedian $214 · 10th to 90th $78 to $3,631Professionalmedian $224 · 10th to 90th $162 to $372
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 $245.47 Median $2,344.23 Typical High $8,317.64 | Facility | None | $245.47 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $245.47 | Professional | None | $177.83 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $147.91 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $123.03 | $147.91 | $173.78 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $56,234.13 | Facility | None | $2,630.27 | $3,019.95 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $416.87 | Professional | None | $239.88 | $251.19 | $416.87 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $173.78 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $165.96 | $173.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $147.91 Typical High $275.42 | Facility | None | $50.12 | $147.91 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $380.19 | Professional | None | $151.36 | $204.17 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $457.09 | Professional | None | $338.84 | $457.09 | $457.09 |
Geisinger Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $288.40 | Facility | None | $131.83 | $165.96 | $288.40 |
Geisinger Setting Professional Modifier None Typical Low $114.82 Median $251.19 Typical High $426.58 | Professional | None | $114.82 | $251.19 | $426.58 |
Highmark BCBS Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,344.23 Typical High $8,128.31 | Facility | None | $478.63 | $2,344.23 | $8,128.31 |
Martin's Point Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $245.47 | Professional | None | $177.83 | $208.93 | $245.47 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $123.03 | $144.54 | $173.78 |
Oscar Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $338.84 | Professional | None | $223.87 | $223.87 | $338.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $194.98 Median $229.09 Typical High $457.09 | Facility | None | $194.98 | $229.09 | $457.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | None | $194.98 | $194.98 | $229.09 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $346.74 | Professional | None | $154.88 | $229.09 | $346.74 |
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 $87.10 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $87.10 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $35.48 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $158.49 Typical High $186.21 | Professional | 54 · Surgery only | $131.83 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $31.62 Typical High $37.15 | Professional | 55 · Aftercare only | $26.30 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $17.78 | $20.89 | $24.55 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $380.19 Typical High $630.96 | Professional | 50 · Both sides | $363.08 | $380.19 | $630.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $87.10 | $102.33 | $123.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $35.48 | $41.69 | $48.98 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $131.83 | $154.88 | $186.21 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $26.30 | $30.90 | $37.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $17.78 | $20.42 | $24.55 |
Where Pennsylvania sits
The same service costs 5.0 times more in Alaska than in Florida. 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· 39th of 51
$224
AK $832FL $166
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.