How much rates vary
Facilitymedian $1,905 · 10th to 90th $661 to $5,623Professionalmedian $1,318 · 10th to 90th $331 to $2,344
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 $354.81 Median $1,096.48 Typical High $1,862.09 | Professional | None | $354.81 | $1,096.48 | $1,862.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $346.74 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $251.19 | $346.74 | $1,318.26 |
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 $1,318.26 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,318.26 | $2,041.74 | $2,570.40 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,621.81 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,621.81 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,548.82 Typical High $2,691.53 | Facility | None | $524.81 | $1,548.82 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $724.44 Typical High $2,344.23 | Professional | None | $295.12 | $724.44 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,754.23 | Professional | None | $2,630.27 | $2,630.27 | $2,754.23 |
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 $457.09 Median $1,819.70 Typical High $2,884.03 | Professional | None | $457.09 | $1,819.70 | $2,884.03 |
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 $354.81 Median $1,096.48 Typical High $1,862.09 | Professional | None | $354.81 | $1,096.48 | $1,862.09 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $346.74 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $251.19 | $346.74 | $1,318.26 |
Oscar Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
UPMC Health Plan Setting Facility Modifier None Typical Low $323.59 Median $1,096.48 Typical High $1,698.24 | Facility | None | $323.59 | $1,096.48 | $1,698.24 |
UPMC Health Plan Setting Professional Modifier None Typical Low $323.59 Median $1,380.38 Typical High $1,698.24 | Professional | None | $323.59 | $1,380.38 | $1,698.24 |
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 $331.13 Median $1,122.02 Typical High $2,398.83 | Professional | None | $331.13 | $1,122.02 | $2,398.83 |
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 $177.83 Median $245.47 Typical High $933.25 | Professional | 52 · Reduced service | $177.83 | $245.47 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $100.00 Typical High $380.19 | Professional | 53 · Discontinued | $70.79 | $100.00 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $371.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $269.15 | $371.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $74.13 Typical High $281.84 | Professional | 55 · Aftercare only | $53.70 | $74.13 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $48.98 Typical High $186.21 | Professional | 56 · Pre-op care only | $35.48 | $48.98 | $186.21 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $3,019.95 Typical High $3,801.89 | Professional | 50 · Both sides | $1,995.26 | $3,019.95 | $3,801.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $245.47 Typical High $933.25 | Professional | 52 · Reduced service | $177.83 | $245.47 | $933.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $100.00 Typical High $380.19 | Professional | 53 · Discontinued | $70.79 | $100.00 | $380.19 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $371.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $269.15 | $371.54 | $1,412.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $74.13 Typical High $281.84 | Professional | 55 · Aftercare only | $53.70 | $74.13 | $281.84 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $48.98 Typical High $186.21 | Professional | 56 · Pre-op care only | $35.48 | $48.98 | $186.21 |
Where Pennsylvania sits
The same service costs 5.8 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
$1,413
AK $3,548NE $617
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.