How much rates vary
Facilitymedian $355 · 10th to 90th $100 to $3,802Professionalmedian $141 · 10th to 90th $117 to $214
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 $154.88 Median $2,344.23 Typical High $8,128.31 | Facility | None | $154.88 | $2,344.23 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $154.88 | Professional | None | $112.20 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $67.61 Typical High $77.62 | Professional | 52 · Reduced service | $56.23 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $22.91 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $102.33 Typical High $117.49 | Professional | 54 · Surgery only | $85.11 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $16.98 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.22 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $95.50 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $79.43 | $95.50 | $109.65 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $56,234.13 | Facility | None | $3,981.07 | $4,365.16 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $263.03 | Professional | None | $208.93 | $239.88 | $263.03 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $125.89 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $120.23 | $125.89 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $323.59 Typical High $562.34 | Facility | None | $165.96 | $323.59 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $251.19 | Professional | None | $123.03 | $141.25 | $251.19 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $263.03 | Professional | None | $199.53 | $263.03 | $263.03 |
Geisinger Setting Facility Modifier None Typical Low $147.91 Median $186.21 Typical High $323.59 | Facility | None | $147.91 | $186.21 | $323.59 |
Geisinger Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $316.23 | Professional | None | $114.82 | $173.78 | $316.23 |
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 $112.20 Median $134.90 Typical High $154.88 | Professional | None | $112.20 | $134.90 | $154.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $67.61 Typical High $77.62 | Professional | 52 · Reduced service | $56.23 | $67.61 | $77.62 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $22.91 | $26.92 | $30.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $102.33 Typical High $117.49 | Professional | 54 · Surgery only | $85.11 | $102.33 | $117.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $16.98 | $20.42 | $23.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.22 | $13.49 | $15.49 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $95.50 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $79.43 | $95.50 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $302.00 | Professional | None | $177.83 | $190.55 | $302.00 |
UPMC Health Plan Setting Facility Modifier None Typical Low $123.03 Median $977.24 Typical High $1,949.84 | Facility | None | $123.03 | $977.24 | $1,949.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $162.18 | Professional | None | $123.03 | $144.54 | $162.18 |
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 $128.82 Median $154.88 Typical High $229.09 | Professional | None | $128.82 | $154.88 | $229.09 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | AS · PA/NP assist | $17.78 | $17.78 | $17.78 |
Where Pennsylvania sits
The same service costs 3.8 times more in Alaska than in Delaware. 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· 46th of 51
$145
AK $513DE $135
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.