How much rates vary
Facilitymedian $3,090 · 10th to 90th $955 to $7,762Professionalmedian $1,288 · 10th to 90th $1,096 to $2,089
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 $1,230.27 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,230.27 | $1,318.26 | $1,380.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $977.24 |
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 $1,548.82 Median $1,737.80 Typical High $56,234.13 | Professional | None | $1,548.82 | $1,737.80 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,548.82 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $954.99 | $1,548.82 | $1,819.70 |
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 $1,096.48 Median $1,258.93 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,258.93 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,905.46 | $1,905.46 | $1,995.26 |
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 $1,096.48 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,513.56 | $2,511.89 |
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 $1,230.27 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,230.27 | $1,318.26 | $1,380.38 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $977.24 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,445.44 | $2,398.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,122.02 Median $2,570.40 Typical High $5,011.87 | Facility | None | $1,122.02 | $2,570.40 | $5,011.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,258.93 | Professional | None | $1,122.02 | $1,122.02 | $1,258.93 |
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 $1,023.29 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,288.25 | $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 $616.60 Median $660.69 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,047.13 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $199.53 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $138.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $660.69 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $660.69 | $691.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $263.03 | $275.42 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,047.13 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,047.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $199.53 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $199.53 | $208.93 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $138.04 |
Where Pennsylvania sits
The same service costs 6.6 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
$1,380
AK $5,248TX $794
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.