How much rates vary
Facilitymedian $794 · 10th to 90th $240 to $6,310Professionalmedian $1,288 · 10th to 90th $1,047 to $2,089
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 $1,148.15 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $912.01 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $56,234.13 | Professional | None | $1,737.80 | $1,737.80 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,412.54 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $954.99 | $1,412.54 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $660.69 Typical High $2,290.87 | Facility | None | $380.19 | $660.69 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,174.90 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,862.09 | Professional | None | $1,698.24 | $1,698.24 | $1,862.09 |
Geisinger Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $3,548.13 | Professional | None | $1,096.48 | $1,348.96 | $3,548.13 |
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 $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,318.26 | $1,318.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $912.01 |
Oscar Health Setting Professional Modifier None Typical Low $15.14 Median $1,288.25 Typical High $2,238.72 | Professional | None | $15.14 | $1,288.25 | $2,238.72 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,071.52 | Facility | None | $1,047.13 | $1,047.13 | $1,071.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,071.52 | Professional | None | $1,047.13 | $1,047.13 | $1,071.52 |
United Setting Facility Modifier None Typical Low $199.53 Median $562.34 Typical High $4,265.80 | Facility | None | $199.53 | $562.34 | $4,265.80 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,318.26 | $2,290.87 |
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 $588.84 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $891.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $199.53 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $131.83 | $131.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $588.84 | $660.69 | $660.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $263.03 | $263.03 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $891.25 | $977.24 | $977.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $199.53 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $199.53 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $131.83 | $131.83 |
Where Pennsylvania sits
The same service costs 9.9 times more in Alabama than in Maryland. 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.
Physician feeFacility fee
AL $18,241MD $1,851
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.