How much rates vary
Facilitymedian $2,570 · 10th to 90th $589 to $7,244Professionalmedian $398 · 10th to 90th $347 to $708
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 $676.08 Median $4,073.80 Typical High $8,317.64 | Facility | None | $676.08 | $4,073.80 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $398.11 | Professional | None | $346.74 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $263.03 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $239.88 | $263.03 | $281.84 |
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 $398.11 Median $416.87 Typical High $741.31 | Professional | None | $398.11 | $416.87 | $741.31 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $281.84 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $275.42 | $281.84 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $5,888.44 | Facility | None | $501.19 | $2,691.53 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $851.14 | Professional | None | $346.74 | $398.11 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $676.08 | Professional | None | $489.78 | $676.08 | $676.08 |
Geisinger Setting Facility Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $7,943.28 | Facility | None | $3,630.78 | $4,466.84 | $7,943.28 |
Geisinger Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $758.58 | Professional | None | $257.04 | $436.52 | $758.58 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $398.11 | Professional | None | $346.74 | $363.08 | $398.11 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $251.19 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $239.88 | $251.19 | $281.84 |
Oscar Health Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $758.58 | Professional | None | $467.74 | $707.95 | $758.58 |
UPMC Health Plan Setting Facility Modifier None Typical Low $380.19 Median $1,479.11 Typical High $3,019.95 | Facility | None | $380.19 | $1,479.11 | $3,019.95 |
UPMC Health Plan Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $588.84 | Professional | None | $380.19 | $407.38 | $588.84 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $6,025.60 | Facility | None | $812.83 | $1,318.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $645.65 | Professional | None | $331.13 | $416.87 | $645.65 |
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 $173.78 Median $186.21 Typical High $199.53 | Professional | 52 · Reduced service | $173.78 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $302.00 | Professional | 54 · Surgery only | $257.04 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $60.26 | Professional | 55 · Aftercare only | $52.48 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $34.67 | $37.15 | $39.81 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $616.60 Typical High $1,122.02 | Professional | 50 · Both sides | $602.56 | $616.60 | $1,122.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $173.78 | $181.97 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $72.44 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $72.44 | $81.28 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $269.15 Typical High $302.00 | Professional | 54 · Surgery only | $257.04 | $269.15 | $302.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $53.70 Typical High $60.26 | Professional | 55 · Aftercare only | $52.48 | $53.70 | $60.26 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $36.31 Typical High $39.81 | Professional | 56 · Pre-op care only | $34.67 | $36.31 | $39.81 |
Where Pennsylvania sits
The same service costs 7.2 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· 40th of 51
$407
AK $1,622TX $224
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.