How much rates vary
Facilitymedian $309 · 10th to 90th $78 to $4,169Professionalmedian $204 · 10th to 90th $115 to $363
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 $302.00 Median $2,344.23 Typical High $8,317.64 | Facility | None | $302.00 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $234.42 Typical High $302.00 | Professional | None | $114.82 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $117.49 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $81.28 | $117.49 | $208.93 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $56,234.13 | Facility | None | $2,511.89 | $2,570.40 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $302.00 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $204.17 | $302.00 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $234.42 Typical High $416.87 | Facility | None | $50.12 | $234.42 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $416.87 | Professional | None | $109.65 | $199.53 | $416.87 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $457.09 | Professional | None | $446.68 | $446.68 | $457.09 |
Geisinger Setting Facility Modifier None Typical Low $208.93 Median $257.04 Typical High $457.09 | Facility | None | $208.93 | $257.04 | $457.09 |
Geisinger Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $436.52 | Professional | None | $120.23 | $251.19 | $436.52 |
Highmark BCBS Setting Facility Modifier None Typical Low $724.44 Median $912.01 Typical High $6,025.60 | Facility | None | $724.44 | $912.01 | $6,025.60 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $7,244.36 | Facility | None | $478.63 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $114.82 Median $234.42 Typical High $302.00 | Professional | None | $114.82 | $234.42 | $302.00 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $117.49 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $81.28 | $117.49 | $208.93 |
Oscar Health Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $478.63 | Professional | None | $165.96 | $173.78 | $478.63 |
UPMC Health Plan Setting Facility Modifier None Typical Low $109.65 Median $2,454.71 Typical High $5,623.41 | Facility | None | $109.65 | $2,454.71 | $5,623.41 |
UPMC Health Plan Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $263.03 | Professional | None | $109.65 | $147.91 | $263.03 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,698.24 | Facility | None | $77.62 | $158.49 | $1,698.24 |
United Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $398.11 | Professional | None | $107.15 | $213.80 | $398.11 |
10 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 $57.54 Median $83.18 Typical High $151.36 | Professional | 52 · Reduced service | $57.54 | $83.18 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.11 Typical High $60.26 | Professional | 53 · Discontinued | $23.44 | $33.11 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $125.89 Typical High $223.87 | Professional | 54 · Surgery only | $87.10 | $125.89 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.12 Typical High $44.67 | Professional | 55 · Aftercare only | $17.38 | $25.12 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.60 Typical High $30.20 | Professional | 56 · Pre-op care only | $11.48 | $16.60 | $30.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $83.18 Typical High $151.36 | Professional | 52 · Reduced service | $57.54 | $83.18 | $151.36 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.11 Typical High $60.26 | Professional | 53 · Discontinued | $23.44 | $33.11 | $60.26 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $125.89 Typical High $223.87 | Professional | 54 · Surgery only | $87.10 | $125.89 | $223.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.12 Typical High $44.67 | Professional | 55 · Aftercare only | $17.38 | $25.12 | $44.67 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.60 Typical High $30.20 | Professional | 56 · Pre-op care only | $11.48 | $16.60 | $30.20 |
Where Pennsylvania sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 35th of 51
$224
AK $562KY $145
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.