How much rates vary
Facilitymedian $2,455 · 10th to 90th $724 to $6,457Professionalmedian $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 $616.60 | Professional | None | $512.86 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $398.11 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $363.08 | $398.11 | $407.38 |
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 $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $616.60 Median $2,187.76 Typical High $3,715.35 | Facility | None | $616.60 | $2,187.76 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $1,000.00 | Professional | None | $446.68 | $524.81 | $1,000.00 |
Emblem Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $831.76 | Professional | None | $758.58 | $758.58 | $831.76 |
Geisinger Setting Facility Modifier None Typical Low $2,238.72 Median $2,818.38 Typical High $4,897.79 | Facility | None | $2,238.72 | $2,818.38 | $4,897.79 |
Geisinger Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,023.29 | Professional | None | $467.74 | $660.69 | $1,023.29 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $4,570.88 Typical High $8,511.38 | Facility | None | $831.76 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $602.56 | Professional | None | $512.86 | $575.44 | $602.56 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $398.11 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $363.08 | $398.11 | $407.38 |
Oscar Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $954.99 | Professional | None | $549.54 | $549.54 | $954.99 |
UPMC Health Plan Setting Facility Modifier None Typical Low $457.09 Median $2,137.96 Typical High $4,168.69 | Facility | None | $457.09 | $2,137.96 | $4,168.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $467.74 | Professional | None | $457.09 | $457.09 | $467.74 |
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 $446.68 Median $575.44 Typical High $1,000.00 | Professional | None | $446.68 | $575.44 | $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 $102.33 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $57.54 |
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 $102.33 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $102.33 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $426.58 | $436.52 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $87.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $57.54 |
Where Pennsylvania sits
The same service costs 5.4 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· 37th of 51
$741
AK $2,630TX $490
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.