How much rates vary
Facilitymedian $794 · 10th to 90th $240 to $6,310Professionalmedian $871 · 10th to 90th $776 to $1,380
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 $831.76 Median $4,897.79 Typical High $8,511.38 | Facility | None | $831.76 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $870.96 | Professional | None | $776.25 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $588.84 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $588.84 | $616.60 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $56,234.13 | Professional | None | $1,288.25 | $1,288.25 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $977.24 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $616.60 | $977.24 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $676.08 Typical High $2,290.87 | Facility | None | $120.23 | $676.08 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,479.11 | Professional | None | $776.25 | $870.96 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,258.93 | $1,380.38 |
Geisinger Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,698.24 | Professional | None | $812.83 | $1,071.52 | $1,698.24 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $8,709.64 | Facility | None | $831.76 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $870.96 | Professional | None | $776.25 | $831.76 | $870.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $588.84 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $588.84 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $16.98 Median $1,148.15 Typical High $1,698.24 | Professional | None | $16.98 | $1,148.15 | $1,698.24 |
UPMC Health Plan Setting Facility Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,000.00 | Facility | None | $794.33 | $1,000.00 | $1,000.00 |
UPMC Health Plan Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | None | $794.33 | $1,000.00 | $1,000.00 |
United Setting Facility Modifier None Typical Low $199.53 Median $562.34 Typical High $4,265.80 | Facility | None | $199.53 | $562.34 | $4,265.80 |
United Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,698.24 | Professional | None | $707.95 | $912.01 | $1,698.24 |
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 $389.05 Median $416.87 Typical High $436.52 | Professional | 52 · Reduced service | $389.05 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $154.88 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $87.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $416.87 Typical High $436.52 | Professional | 52 · Reduced service | $389.05 | $416.87 | $436.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $154.88 | $165.96 | $173.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $630.96 | $660.69 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $125.89 | $131.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $87.10 |
Where Pennsylvania sits
The same service costs 6.2 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· 40th of 51
$871
AK $3,311TX $537
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.