How much rates vary
Facilitymedian $3,715 · 10th to 90th $724 to $8,511Professionalmedian $1,096 · 10th to 90th $955 to $1,862
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 $891.25 Median $4,265.80 Typical High $8,511.38 | Facility | None | $891.25 | $4,265.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,096.48 | Professional | None | $954.99 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $1,047.13 Median $1,096.48 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,096.48 | $1,995.26 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,659.59 Typical High $3,019.95 | Professional | 50 · Both sides | $1,584.89 | $1,659.59 | $3,019.95 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $1,380.38 |
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 $1,000.00 Median $1,047.13 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,047.13 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,698.24 | $1,698.24 |
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 $977.24 Median $1,288.25 Typical High $2,398.83 | Professional | None | $977.24 | $1,288.25 | $2,398.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $19,498.45 Median $20,417.38 Typical High $23,988.33 | Facility | None | $19,498.45 | $20,417.38 | $23,988.33 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,288.25 | $1,698.24 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $4,265.80 Typical High $8,709.64 | Facility | None | $954.99 | $4,265.80 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,096.48 | Professional | None | $954.99 | $1,023.29 | $1,096.48 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $758.58 |
Oscar Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,230.27 | $2,089.30 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,023.29 Median $2,454.71 Typical High $4,265.80 | Facility | None | $1,023.29 | $2,454.71 | $4,265.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $977.24 Median $1,148.15 Typical High $1,698.24 | Professional | None | $977.24 | $1,148.15 | $1,698.24 |
6 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 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $154.88 Typical High $165.96 | Professional | 55 · Aftercare only | $141.25 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $109.65 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $758.58 | $812.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $154.88 Typical High $165.96 | Professional | 55 · Aftercare only | $141.25 | $154.88 | $165.96 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $109.65 |
Where Pennsylvania sits
The same service costs 7.6 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· 41st of 51
$1,096
AK $4,266TX $562
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.