How much rates vary
Facilitymedian $813 · 10th to 90th $275 to $4,571Professionalmedian $209 · 10th to 90th $112 to $363
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 $288.40 Median $3,090.30 Typical High $8,511.38 | Facility | None | $288.40 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $223.87 Typical High $288.40 | Professional | None | $117.49 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $83.18 Typical High $144.54 | Professional | 52 · Reduced service | $58.88 | $83.18 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.11 Typical High $57.54 | Professional | 53 · Discontinued | $23.44 | $33.11 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $123.03 Typical High $213.80 | Professional | 54 · Surgery only | $89.13 | $123.03 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $24.55 Typical High $42.66 | Professional | 55 · Aftercare only | $17.78 | $24.55 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.60 Typical High $28.84 | Professional | 56 · Pre-op care only | $11.75 | $16.60 | $28.84 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $56,234.13 | Professional | None | $173.78 | $173.78 | $56,234.13 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $741.31 Typical High $1,318.26 | Facility | None | $478.63 | $741.31 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $389.05 | Professional | None | $104.71 | $194.98 | $389.05 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $446.68 | Professional | None | $426.58 | $426.58 | $446.68 |
Geisinger Setting Facility Modifier None Typical Low $630.96 Median $794.33 Typical High $1,380.38 | Facility | None | $630.96 | $794.33 | $1,380.38 |
Geisinger Setting Professional Modifier None Typical Low $141.25 Median $288.40 Typical High $426.58 | Professional | None | $141.25 | $288.40 | $426.58 |
Martin's Point Setting Facility Modifier None Typical Low $575.44 Median $2,754.23 Typical High $8,709.64 | Facility | None | $575.44 | $2,754.23 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $288.40 | Professional | None | $117.49 | $229.09 | $288.40 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $83.18 Typical High $144.54 | Professional | 52 · Reduced service | $58.88 | $83.18 | $144.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.11 Typical High $57.54 | Professional | 53 · Discontinued | $23.44 | $33.11 | $57.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $123.03 Typical High $213.80 | Professional | 54 · Surgery only | $89.13 | $123.03 | $213.80 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $24.55 Typical High $42.66 | Professional | 55 · Aftercare only | $17.78 | $24.55 | $42.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.60 Typical High $28.84 | Professional | 56 · Pre-op care only | $11.75 | $16.60 | $28.84 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $407.38 | Professional | None | $204.17 | $204.17 | $407.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $123.03 Median $1,071.52 Typical High $2,511.89 | Facility | None | $123.03 | $1,071.52 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $223.87 | Professional | None | $107.15 | $186.21 | $223.87 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $3,311.31 | Facility | None | $199.53 | $436.52 | $3,311.31 |
United Setting Professional Modifier None Typical Low $112.20 Median $218.78 Typical High $407.38 | Professional | None | $112.20 | $218.78 | $407.38 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $251.19 |
Where Pennsylvania sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 38th of 51
$251
AK $776KY $182
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.