How much rates vary
Facilitymedian $2,884 · 10th to 90th $692 to $6,918Professionalmedian $1,738 · 10th to 90th $1,514 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 $954.99 Median $3,090.30 Typical High $8,511.38 | Facility | None | $954.99 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,659.59 | $1,778.28 | $1,862.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,258.93 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,258.93 | $1,318.26 |
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 $2,754.23 Median $2,754.23 Typical High $56,234.13 | Professional | None | $2,754.23 | $2,754.23 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,089.30 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,089.30 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,187.76 Typical High $4,897.79 | Facility | None | $478.63 | $2,187.76 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,584.89 | $1,778.28 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,691.53 | Professional | None | $2,570.40 | $2,570.40 | $2,691.53 |
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 $1,513.56 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,513.56 | $2,089.30 | $3,388.44 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $8,317.64 | Facility | None | $954.99 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,659.59 | $1,778.28 | $1,862.09 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,258.93 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,258.93 | $1,318.26 |
Oscar Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,548.82 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $3,019.95 | Facility | None | $1,096.48 | $1,698.24 | $3,019.95 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,513.56 | $1,513.56 | $1,698.24 |
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 $1,412.54 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,412.54 | $1,778.28 | $3,467.37 |
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 $831.76 Median $891.25 Typical High $933.25 | Professional | 52 · Reduced service | $831.76 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $354.81 Typical High $380.19 | Professional | 53 · Discontinued | $331.13 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,258.93 | $1,348.96 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $281.84 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $177.83 Typical High $186.21 | Professional | 56 · Pre-op care only | $165.96 | $177.83 | $186.21 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $891.25 Typical High $933.25 | Professional | 52 · Reduced service | $831.76 | $891.25 | $933.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $354.81 Typical High $380.19 | Professional | 53 · Discontinued | $331.13 | $354.81 | $380.19 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,258.93 | $1,348.96 | $1,412.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $281.84 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $281.84 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $177.83 Typical High $186.21 | Professional | 56 · Pre-op care only | $165.96 | $177.83 | $186.21 |
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· 42nd of 51
$1,862
AK $7,079TX $1,000
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.