How much rates vary
Facilitymedian $3,020 · 10th to 90th $871 to $7,413Professionalmedian $1,259 · 10th to 90th $1,023 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 $1,023.29 Median $4,897.79 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,258.93 | $1,479.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $794.33 | $891.25 | $891.25 |
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 $1,148.15 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,862.09 | $2,884.03 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,412.54 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $870.96 | $1,412.54 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,818.38 Typical High $4,897.79 | Facility | None | $616.60 | $2,818.38 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,380.38 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,778.28 | Professional | None | $1,698.24 | $1,698.24 | $1,778.28 |
Geisinger Setting Facility Modifier None Typical Low $2,951.21 Median $3,630.78 Typical High $6,456.54 | Facility | None | $2,951.21 | $3,630.78 | $6,456.54 |
Geisinger Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,412.54 | $2,238.72 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $4,570.88 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,258.93 | $1,445.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $794.33 | $870.96 | $891.25 |
Oscar Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,288.25 | $2,454.71 |
UPMC Health Plan Setting Facility Modifier None Typical Low $954.99 Median $2,137.96 Typical High $4,168.69 | Facility | None | $954.99 | $2,137.96 | $4,168.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | None | $954.99 | $954.99 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $2,290.87 | Professional | None | $954.99 | $1,202.26 | $2,290.87 |
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 $562.34 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $851.14 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $125.89 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,754.23 Typical High $4,265.80 | Professional | 50 · Both sides | $1,737.80 | $2,754.23 | $4,265.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $616.60 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $616.60 | $630.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $229.09 | $251.19 | $251.19 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $933.25 Typical High $954.99 | Professional | 54 · Surgery only | $851.14 | $933.25 | $954.99 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $186.21 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $186.21 | $190.55 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $125.89 |
Where Pennsylvania sits
The same service costs 6.8 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
$1,349
AK $4,786TX $708
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.