How much rates vary
Facilitymedian $1,995 · 10th to 90th $692 to $5,623Professionalmedian $692 · 10th to 90th $562 to $1,175
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 $691.83 Median $3,890.45 Typical High $8,317.64 | Facility | None | $691.83 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $707.95 | Professional | None | $616.60 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $478.63 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $10,715.19 Typical High $12,022.64 | Facility | None | $3,981.07 | $10,715.19 | $12,022.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $575.44 Median $912.01 Typical High $1,348.96 | Professional | None | $575.44 | $912.01 | $1,348.96 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $741.31 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $478.63 | $741.31 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,513.56 Typical High $2,691.53 | Facility | None | $501.19 | $1,513.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,202.26 | Professional | None | $562.34 | $724.44 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $933.25 | Professional | None | $831.76 | $831.76 | $933.25 |
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 $616.60 Median $794.33 Typical High $1,348.96 | Professional | None | $616.60 | $794.33 | $1,348.96 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $707.95 | Professional | None | $616.60 | $691.83 | $707.95 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $478.63 |
Oscar Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,318.26 | Professional | None | $812.83 | $812.83 | $1,318.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $562.34 Median $1,737.80 Typical High $3,467.37 | Facility | None | $562.34 | $1,737.80 | $3,467.37 |
UPMC Health Plan Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $794.33 | Professional | None | $562.34 | $588.84 | $794.33 |
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 $537.03 Median $758.58 Typical High $1,230.27 | Professional | None | $537.03 | $758.58 | $1,230.27 |
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 $309.03 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $309.03 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $69.18 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,318.26 Typical High $2,041.74 | Professional | 50 · Both sides | $870.96 | $1,318.26 | $2,041.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $309.03 | $346.74 | $346.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $138.04 | $138.04 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $104.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $69.18 |
Where Pennsylvania sits
The same service costs 5.9 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· 42nd of 51
$832
AK $3,236TX $550
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.