How much rates vary
Facilitymedian $1,950 · 10th to 90th $741 to $7,413Professionalmedian $1,122 · 10th to 90th $977 to $1,778
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 $4,897.79 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,122.02 | $1,148.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $776.25 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $724.44 | $776.25 | $794.33 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $56,234.13 | Professional | None | $1,698.24 | $1,698.24 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,318.26 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $812.83 | $1,318.26 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,818.38 Typical High $4,897.79 | Facility | None | $616.60 | $2,818.38 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,949.84 | Professional | None | $933.25 | $1,122.02 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,445.44 | $1,445.44 | $1,548.82 |
Geisinger Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $2,187.76 | Professional | None | $933.25 | $1,258.93 | $2,187.76 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $4,786.30 Typical High $8,511.38 | Facility | None | $1,023.29 | $4,786.30 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,122.02 | $1,148.15 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $776.25 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $724.44 | $776.25 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,445.44 | $2,187.76 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,047.13 Median $2,187.76 Typical High $3,715.35 | Facility | None | $1,047.13 | $2,187.76 | $3,715.35 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,047.13 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $6,025.60 | Facility | None | $812.83 | $1,318.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $2,187.76 | Professional | None | $933.25 | $1,122.02 | $2,187.76 |
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 $512.86 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $512.86 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $223.87 Typical High $229.09 | Professional | 53 · Discontinued | $208.93 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $776.25 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $114.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $512.86 | $549.54 | $575.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $223.87 Typical High $229.09 | Professional | 53 · Discontinued | $208.93 | $223.87 | $229.09 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $776.25 | $831.76 | $851.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $165.96 | $169.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $114.82 |
Where Pennsylvania sits
The same service costs 4.6 times more in Alaska than in Kentucky. 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 $11,283KY $2,440
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.