How much rates vary
Facilitymedian $3,715 · 10th to 90th $676 to $8,511Professionalmedian $562 · 10th to 90th $513 to $977
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 $724.44 Median $4,265.80 Typical High $8,511.38 | Facility | None | $724.44 | $4,265.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $562.34 | Professional | None | $489.78 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $398.11 |
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 $549.54 Median $575.44 Typical High $1,023.29 | Professional | None | $549.54 | $575.44 | $1,023.29 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $398.11 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $380.19 | $398.11 | $707.95 |
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 $512.86 Median $549.54 Typical High $1,202.26 | Professional | None | $512.86 | $549.54 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $891.25 | Professional | None | $660.69 | $891.25 | $891.25 |
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 $512.86 Median $676.08 Typical High $1,148.15 | Professional | None | $512.86 | $676.08 | $1,148.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Highmark BCBS Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $4,073.80 Typical High $8,709.64 | Facility | None | $776.25 | $4,073.80 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $562.34 | Professional | None | $489.78 | $537.03 | $562.34 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,071.52 | Professional | None | $645.65 | $794.33 | $1,071.52 |
UPMC Health Plan Setting Facility Modifier None Typical Low $537.03 Median $1,737.80 Typical High $3,388.44 | Facility | None | $537.03 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | None | $537.03 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,000.00 | Facility | None | $1,698.24 | $3,235.94 | $10,000.00 |
United Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $891.25 | Professional | None | $512.86 | $588.84 | $891.25 |
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 $245.47 Median $269.15 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $97.72 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $371.54 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $56.23 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $851.14 Typical High $1,548.82 | Professional | 50 · Both sides | $831.76 | $851.14 | $1,548.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $263.03 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $97.72 | $107.15 | $114.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $371.54 | $398.11 | $426.58 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $85.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $56.23 |
Where Pennsylvania sits
The same service costs 7.9 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $13,941MT $1,762
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.