How much rates vary
Facilitymedian $195 · 10th to 90th $78 to $3,020Professionalmedian $178 · 10th to 90th $105 to $316
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 $199.53 Median $2,344.23 Typical High $8,317.64 | Facility | None | $199.53 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $199.53 | Professional | None | $104.71 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $102.33 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $72.44 | $102.33 | $141.25 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $8,709.64 | Facility | None | $2,454.71 | $2,570.40 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $354.81 | Professional | None | $177.83 | $288.40 | $354.81 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $234.42 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $144.54 | $234.42 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $141.25 Typical High $263.03 | Facility | None | $50.12 | $141.25 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $302.00 | Professional | None | $95.50 | $173.78 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | None | $309.03 | $309.03 | $323.59 |
Geisinger Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $275.42 | Facility | None | $125.89 | $158.49 | $275.42 |
Geisinger Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $309.03 | Professional | None | $104.71 | $194.98 | $309.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $104.71 Median $173.78 Typical High $199.53 | Professional | None | $104.71 | $173.78 | $199.53 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $102.33 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $72.44 | $102.33 | $141.25 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $354.81 | Professional | None | $141.25 | $147.91 | $354.81 |
UPMC Health Plan Setting Facility Modifier None Typical Low $95.50 Median $194.98 Typical High $457.09 | Facility | None | $95.50 | $194.98 | $457.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $181.97 | Professional | None | $95.50 | $177.83 | $181.97 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $288.40 | Professional | None | $95.50 | $162.18 | $288.40 |
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 $52.48 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $52.48 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $29.51 Typical High $39.81 | Professional | 53 · Discontinued | $20.89 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $109.65 Typical High $151.36 | Professional | 54 · Surgery only | $77.62 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $21.88 Typical High $30.20 | Professional | 55 · Aftercare only | $15.49 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.47 | $14.45 | $19.95 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $436.52 Typical High $524.81 | Professional | 50 · Both sides | $269.15 | $436.52 | $524.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $52.48 | $72.44 | $100.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $29.51 Typical High $39.81 | Professional | 53 · Discontinued | $20.89 | $29.51 | $39.81 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $109.65 Typical High $151.36 | Professional | 54 · Surgery only | $77.62 | $109.65 | $151.36 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $21.88 Typical High $30.20 | Professional | 55 · Aftercare only | $15.49 | $21.88 | $30.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.47 | $14.45 | $19.95 |
Where Pennsylvania sits
The same service costs 4.5 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· 36th of 51
$178
AK $457KY $102
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.