How much rates vary
Facilitymedian $3,090 · 10th to 90th $912 to $7,943Professionalmedian $1,122 · 10th to 90th $912 to $1,950
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 $1,047.13 Median $5,495.41 Typical High $8,709.64 | Facility | None | $1,047.13 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $851.14 |
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 $1,071.52 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,659.59 | $1,995.26 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,258.93 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $812.83 | $1,258.93 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,949.84 | Professional | None | $912.01 | $1,071.52 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,659.59 | $1,737.80 |
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 $891.25 Median $1,288.25 Typical High $2,089.30 | Professional | None | $891.25 | $1,288.25 | $2,089.30 |
Highmark BCBS Setting Facility Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Facility | None | $12,882.50 | $12,882.50 | $12,882.50 |
Martin's Point Setting Facility Modifier None Typical Low $1,148.15 Median $4,897.79 Typical High $8,709.64 | Facility | None | $1,148.15 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,122.02 | $1,202.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $851.14 |
Oscar Health Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,949.84 | Professional | None | $870.96 | $1,047.13 | $1,949.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $891.25 Median $2,570.40 Typical High $5,011.87 | Facility | None | $891.25 | $2,570.40 | $5,011.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Professional | None | $891.25 | $891.25 | $1,096.48 |
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 $870.96 Median $1,096.48 Typical High $2,137.96 | Professional | None | $870.96 | $1,096.48 | $2,137.96 |
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 $537.03 Median $575.44 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $245.47 | Professional | 53 · Discontinued | $213.80 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $120.23 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,454.71 Typical High $2,951.21 | Professional | 50 · Both sides | $1,621.81 | $2,454.71 | $2,951.21 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $575.44 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $575.44 | $602.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $245.47 | Professional | 53 · Discontinued | $213.80 | $229.09 | $245.47 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $870.96 | $912.01 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $181.97 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $120.23 |
Where Pennsylvania sits
The same service costs 3.4 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $11,546MT $3,360
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.