How much rates vary
Facilitymedian $4,467 · 10th to 90th $724 to $13,490Professionalmedian $1,318 · 10th to 90th $1,148 to $2,291
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 $1,148.15 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $933.25 |
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 $1,288.25 Median $1,318.26 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,318.26 | $2,398.83 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $1,995.26 Typical High $3,630.78 | Professional | 50 · Both sides | $1,905.46 | $1,995.26 | $3,630.78 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $8,317.64 Typical High $16,595.87 | Facility | None | $501.19 | $8,317.64 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,288.25 | $2,691.53 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,513.56 | $2,041.74 | $2,041.74 |
Geisinger Setting Facility Modifier None Typical Low $8,317.64 Median $10,471.29 Typical High $18,197.01 | Facility | None | $8,317.64 | $10,471.29 | $18,197.01 |
Geisinger Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,548.82 | $2,754.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $75,857.76 | Facility | None | $7,943.28 | $7,943.28 | $75,857.76 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,584.89 | $2,884.03 |
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 $1,148.15 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,258.93 | $1,318.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $933.25 |
Oscar Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,445.44 | $2,511.89 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,230.27 Median $2,570.40 Typical High $4,073.80 | Facility | None | $1,230.27 | $2,570.40 | $4,073.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | None | $1,230.27 | $1,230.27 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,715.19 | Facility | None | $1,698.24 | $3,235.94 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,412.54 | $2,089.30 |
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 $870.96 Median $933.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $199.53 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $131.83 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $131.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,000.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $199.53 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $199.53 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $131.83 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $131.83 |
Where Pennsylvania sits
The same service costs 8.1 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· 42nd of 51
$1,318
AK $5,248TX $646
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.