How much rates vary
Facilitymedian $1,820 · 10th to 90th $631 to $6,607Professionalmedian $1,148 · 10th to 90th $912 to $1,862
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 $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $724.44 | $794.33 | $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 $1,513.56 Median $1,513.56 Typical High $56,234.13 | Professional | None | $1,513.56 | $1,513.56 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,230.27 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $794.33 | $1,230.27 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,548.82 Typical High $2,691.53 | Facility | None | $501.19 | $1,548.82 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,949.84 | Professional | None | $912.01 | $1,174.90 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,380.38 | $1,380.38 | $1,548.82 |
Geisinger Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,288.25 | $2,238.72 |
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 $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,148.15 | $1,148.15 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $724.44 | $794.33 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $2,137.96 | Professional | None | $912.01 | $912.01 | $2,137.96 |
UPMC Health Plan Setting Facility Modifier None Typical Low $933.25 Median $977.24 Typical High $977.24 | Facility | None | $933.25 | $977.24 | $977.24 |
UPMC Health Plan Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | None | $933.25 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $5,623.41 | Facility | None | $1,148.15 | $1,905.46 | $5,623.41 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,995.26 | Professional | None | $891.25 | $1,258.93 | $1,995.26 |
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 $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $512.86 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $204.17 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $776.25 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $512.86 | $575.44 | $575.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $204.17 | $229.09 | $229.09 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $776.25 | $851.14 | $851.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $169.82 | $169.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $114.82 | $114.82 |
Where Pennsylvania sits
The same service costs 4.6 times more in Wisconsin 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· 45th of 51
$1,148
WI $3,981TX $871
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.