How much rates vary
Facilitymedian $1,778 · 10th to 90th $813 to $7,079Professionalmedian $1,288 · 10th to 90th $1,122 to $2,042
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 $1,202.26 Median $1,288.25 Typical High $1,348.96 | Professional | None | $1,202.26 | $1,288.25 | $1,348.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $933.25 |
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 $1,995.26 Median $1,995.26 Typical High $56,234.13 | Professional | None | $1,995.26 | $1,995.26 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,513.56 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $933.25 | $1,513.56 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,513.56 Typical High $2,884.03 | Facility | None | $707.95 | $1,513.56 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,348.96 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,905.46 | Professional | None | $1,819.70 | $1,819.70 | $1,905.46 |
Geisinger Setting Facility Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $3,162.28 | Facility | None | $1,445.44 | $1,778.28 | $3,162.28 |
Geisinger Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,479.11 | $2,398.83 |
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 $1,202.26 Median $1,288.25 Typical High $1,348.96 | Professional | None | $1,202.26 | $1,288.25 | $1,348.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $933.25 |
Oscar Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,445.44 | $2,454.71 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,230.27 Median $2,511.89 Typical High $5,011.87 | Facility | None | $1,230.27 | $2,511.89 | $5,011.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,570.88 | Facility | None | $812.83 | $1,318.26 | $4,570.88 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,318.26 | $2,570.40 |
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 $602.56 Median $645.65 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $269.15 | Professional | 53 · Discontinued | $239.88 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $1,000.00 | Professional | 54 · Surgery only | $912.01 | $977.24 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $204.17 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $134.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $645.65 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $645.65 | $676.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $269.15 | Professional | 53 · Discontinued | $239.88 | $257.04 | $269.15 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $1,000.00 | Professional | 54 · Surgery only | $912.01 | $977.24 | $1,000.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $204.17 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $204.17 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $134.90 |
Where Pennsylvania sits
The same service costs 3.2 times more in Alaska than in Delaware. 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 $8,931DE $2,772
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.