How much rates vary
Facilitymedian $794 · 10th to 90th $240 to $6,310Professionalmedian $1,175 · 10th to 90th $977 to $1,950
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 $1,096.48 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,148.15 | $1,202.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $851.14 |
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 $1,778.28 Median $1,778.28 Typical High $56,234.13 | Professional | None | $1,778.28 | $1,778.28 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,380.38 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $851.14 | $1,380.38 | $1,737.80 |
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 $1,047.13 Median $1,258.93 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,258.93 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,949.84 | Professional | None | $1,778.28 | $1,778.28 | $1,949.84 |
Geisinger Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,412.54 | $2,398.83 |
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 $1,096.48 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,148.15 | $1,202.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $851.14 |
Oscar Health Setting Professional Modifier None Typical Low $15.14 Median $1,258.93 Typical High $2,238.72 | Professional | None | $15.14 | $1,258.93 | $2,238.72 |
UPMC Health Plan Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Facility | None | $954.99 | $954.99 | $1,096.48 |
UPMC Health Plan Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Professional | None | $954.99 | $954.99 | $1,096.48 |
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 $977.24 Median $1,230.27 Typical High $2,344.23 | Professional | None | $977.24 | $1,230.27 | $2,344.23 |
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 $549.54 Median $588.84 Typical High $602.56 | Professional | 52 · Reduced service | $549.54 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $218.78 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $120.23 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $120.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $588.84 Typical High $602.56 | Professional | 52 · Reduced service | $549.54 | $588.84 | $602.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $218.78 | $234.42 | $239.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $870.96 | $912.01 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $181.97 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $120.23 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $120.23 |
Where Pennsylvania sits
The same service costs 6.8 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
$1,148
AK $4,571TX $676
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.