How much rates vary
Facilitymedian $2,399 · 10th to 90th $631 to $6,310Professionalmedian $575 · 10th to 90th $457 to $933
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 $812.83 Median $4,897.79 Typical High $8,511.38 | Facility | None | $812.83 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $707.95 | Professional | None | $512.86 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $407.38 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $56,234.13 | Professional | None | $416.87 | $416.87 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $616.60 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $398.11 | $616.60 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,041.74 Typical High $4,073.80 | Facility | None | $501.19 | $2,041.74 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $977.24 | Professional | None | $457.09 | $537.03 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | None | $676.08 | $676.08 | $758.58 |
Geisinger Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $4,466.84 | Facility | None | $2,041.74 | $2,511.89 | $4,466.84 |
Geisinger Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,047.13 | Professional | None | $478.63 | $630.96 | $1,047.13 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $4,786.30 Typical High $8,511.38 | Facility | None | $831.76 | $4,786.30 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $707.95 | Professional | None | $512.86 | $575.44 | $707.95 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $407.38 |
Oscar Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,071.52 | Professional | None | $616.60 | $616.60 | $1,071.52 |
UPMC Health Plan Setting Facility Modifier None Typical Low $467.74 Median $3,090.30 Typical High $5,370.32 | Facility | None | $467.74 | $3,090.30 | $5,370.32 |
UPMC Health Plan Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $512.86 | Professional | None | $467.74 | $489.78 | $512.86 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $1,000.00 | Professional | None | $446.68 | $616.60 | $1,000.00 |
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 $257.04 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $58.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $257.04 | $288.40 | $288.40 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $114.82 | $117.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $436.52 | $436.52 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $58.88 |
Where Pennsylvania sits
The same service costs 5.4 times more in Connecticut than in Montana. 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
CT $7,713MT $1,433
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.