How much rates vary
Facilitymedian $2,455 · 10th to 90th $646 to $7,079Professionalmedian $550 · 10th to 90th $490 to $955
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 $524.81 Typical High $562.34 | Professional | None | $489.78 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $398.11 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $8,709.64 | Facility | None | $3,981.07 | $7,413.10 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $1,023.29 | Professional | None | $549.54 | $562.34 | $1,023.29 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $389.05 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $380.19 | $389.05 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,584.89 Typical High $2,691.53 | Facility | None | $524.81 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $1,174.90 | Professional | None | $489.78 | $549.54 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $912.01 | Professional | None | $676.08 | $912.01 | $912.01 |
Geisinger Setting Facility Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,467.37 | Facility | None | $1,584.89 | $1,995.26 | $3,467.37 |
Geisinger Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,096.48 | Professional | None | $501.19 | $645.65 | $1,096.48 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Highmark BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $512.86 Typical High $562.34 | Professional | None | $489.78 | $512.86 | $562.34 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,000.00 | Professional | None | $562.34 | $562.34 | $1,000.00 |
UPMC Health Plan Setting Facility Modifier None Typical Low $467.74 Median $2,630.27 Typical High $4,466.84 | Facility | None | $467.74 | $2,630.27 | $4,466.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | None | $467.74 | $467.74 | $537.03 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $7,079.46 | Facility | None | $1,698.24 | $3,235.94 | $7,079.46 |
United Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $870.96 | Professional | None | $467.74 | $575.44 | $870.96 |
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 $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $56.23 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $851.14 Typical High $1,513.56 | Professional | 50 · Both sides | $812.83 | $851.14 | $1,513.56 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $257.04 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $102.33 | $112.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $380.19 | $426.58 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $85.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $56.23 |
Where Pennsylvania sits
The same service costs 7.9 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
$562
AK $2,239TX $282
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.