How much rates vary
Facilitymedian $1,950 · 10th to 90th $676 to $5,495Professionalmedian $1,175 · 10th to 90th $389 to $2,138
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 $676.08 Median $3,801.89 Typical High $8,317.64 | Facility | None | $676.08 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $1,096.48 Typical High $1,584.89 | Professional | None | $407.38 | $1,096.48 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $398.11 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $288.40 | $398.11 | $1,122.02 |
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 $1,148.15 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,737.80 | $2,398.83 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,380.38 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $912.01 | $1,380.38 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,548.82 Typical High $2,884.03 | Facility | None | $524.81 | $1,548.82 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $831.76 Typical High $1,995.26 | Professional | None | $346.74 | $831.76 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,344.23 | Professional | None | $2,238.72 | $2,238.72 | $2,344.23 |
Geisinger Setting Facility Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $3,467.37 | Facility | None | $1,584.89 | $1,949.84 | $3,467.37 |
Geisinger Setting Professional Modifier None Typical Low $524.81 Median $1,584.89 Typical High $2,754.23 | Professional | None | $524.81 | $1,584.89 | $2,754.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $7,585.78 Typical High $14,125.38 | Facility | None | $3,311.31 | $7,585.78 | $14,125.38 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,715.35 Typical High $8,317.64 | Facility | None | $776.25 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $407.38 Median $1,096.48 Typical High $1,584.89 | Professional | None | $407.38 | $1,096.48 | $1,584.89 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $398.11 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $288.40 | $398.11 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,659.59 | $2,511.89 |
UPMC Health Plan Setting Facility Modifier None Typical Low $371.54 Median $1,412.54 Typical High $3,311.31 | Facility | None | $371.54 | $1,412.54 | $3,311.31 |
UPMC Health Plan Setting Professional Modifier None Typical Low $371.54 Median $1,174.90 Typical High $3,311.31 | Professional | None | $371.54 | $1,174.90 | $3,311.31 |
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 $380.19 Median $1,096.48 Typical High $2,137.96 | Professional | None | $380.19 | $1,096.48 | $2,137.96 |
11 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 $204.17 Median $288.40 Typical High $794.33 | Professional | 52 · Reduced service | $204.17 | $288.40 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $114.82 Typical High $316.23 | Professional | 53 · Discontinued | $81.28 | $114.82 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $426.58 Typical High $1,202.26 | Professional | 54 · Surgery only | $309.03 | $426.58 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $85.11 Typical High $239.88 | Professional | 55 · Aftercare only | $61.66 | $85.11 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $57.54 Typical High $158.49 | Professional | 56 · Pre-op care only | $40.74 | $57.54 | $158.49 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,570.40 Typical High $3,548.13 | Professional | 50 · Both sides | $1,698.24 | $2,570.40 | $3,548.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $288.40 Typical High $794.33 | Professional | 52 · Reduced service | $204.17 | $288.40 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $114.82 Typical High $316.23 | Professional | 53 · Discontinued | $81.28 | $114.82 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $426.58 Typical High $1,202.26 | Professional | 54 · Surgery only | $309.03 | $426.58 | $1,202.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $85.11 Typical High $239.88 | Professional | 55 · Aftercare only | $61.66 | $85.11 | $239.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $57.54 Typical High $158.49 | Professional | 56 · Pre-op care only | $40.74 | $57.54 | $158.49 |
Where Pennsylvania sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 36th of 51
$1,318
AK $3,020NE $692
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.