How much rates vary
Facilitymedian $3,020 · 10th to 90th $724 to $7,943Professionalmedian $1,585 · 10th to 90th $1,380 to $2,818
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 $5,495.41 Typical High $8,709.64 | Facility | None | $1,023.29 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,548.82 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,122.02 |
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 $1,479.11 Median $2,398.83 Typical High $2,884.03 | Professional | None | $1,479.11 | $2,398.83 | $2,884.03 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,819.70 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,819.70 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $4,897.79 | Facility | None | $501.19 | $2,691.53 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,584.89 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,238.72 | Professional | None | $2,137.96 | $2,137.96 | $2,238.72 |
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 $1,348.96 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,778.28 | $2,754.23 |
Martin's Point Setting Facility Modifier None Typical Low $1,047.13 Median $4,897.79 Typical High $8,709.64 | Facility | None | $1,047.13 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,548.82 | $1,584.89 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $5,888.44 | Professional | None | $1,698.24 | $1,737.80 | $5,888.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,445.44 | $1,584.89 | $1,584.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,584.89 | $1,584.89 |
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 $1,258.93 Median $1,584.89 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,584.89 | $2,951.21 |
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 $724.44 Median $776.25 Typical High $794.33 | Professional | 52 · Reduced service | $724.44 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $309.03 Typical High $316.23 | Professional | 53 · Discontinued | $288.40 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $229.09 Typical High $239.88 | Professional | 55 · Aftercare only | $213.80 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $154.88 Typical High $158.49 | Professional | 56 · Pre-op care only | $144.54 | $154.88 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $776.25 Typical High $794.33 | Professional | 52 · Reduced service | $724.44 | $776.25 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $309.03 Typical High $316.23 | Professional | 53 · Discontinued | $288.40 | $309.03 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,202.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $229.09 Typical High $239.88 | Professional | 55 · Aftercare only | $213.80 | $229.09 | $239.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $154.88 Typical High $158.49 | Professional | 56 · Pre-op care only | $144.54 | $154.88 | $158.49 |
Where Pennsylvania sits
The same service costs 7.1 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· 43rd of 51
$1,585
AK $6,026TX $851
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.