How much rates vary
Facilitymedian $1,622 · 10th to 90th $537 to $5,012Professionalmedian $355 · 10th to 90th $275 to $562
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 $398.11 Median $2,754.23 Typical High $8,317.64 | Facility | None | $398.11 | $2,754.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $398.11 | Professional | None | $275.42 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $186.21 | $239.88 | $281.84 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $8,709.64 | Facility | None | $3,981.07 | $4,365.16 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $56,234.13 | Professional | None | $446.68 | $446.68 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $478.63 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $295.12 | $478.63 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,412.54 Typical High $2,398.83 | Facility | None | $478.63 | $1,412.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $602.56 | Professional | None | $269.15 | $354.81 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $645.65 | Professional | None | $630.96 | $630.96 | $645.65 |
Geisinger Setting Facility Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $3,162.28 | Facility | None | $1,445.44 | $1,778.28 | $3,162.28 |
Geisinger Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $660.69 | Professional | None | $302.00 | $407.38 | $660.69 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $7,244.36 Typical High $8,317.64 | Facility | None | $5,495.41 | $7,244.36 | $8,317.64 |
Martin's Point Setting Facility Modifier None Typical Low $549.54 Median $2,630.27 Typical High $8,317.64 | Facility | None | $549.54 | $2,630.27 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $398.11 | Professional | None | $275.42 | $346.74 | $398.11 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $181.97 | $239.88 | $281.84 |
Oscar Health Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $741.31 | Professional | None | $338.84 | $389.05 | $741.31 |
UPMC Health Plan Setting Facility Modifier None Typical Low $295.12 Median $1,071.52 Typical High $2,511.89 | Facility | None | $295.12 | $1,071.52 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $371.54 | Professional | None | $275.42 | $354.81 | $371.54 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,570.88 | Facility | None | $812.83 | $1,318.26 | $4,570.88 |
United Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $630.96 | Professional | None | $263.03 | $380.19 | $630.96 |
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 $131.83 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $131.83 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $79.43 | Professional | 53 · Discontinued | $53.70 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $199.53 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $39.81 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.30 | $34.67 | $39.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $131.83 | $173.78 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $69.18 Typical High $79.43 | Professional | 53 · Discontinued | $52.48 | $69.18 | $79.43 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $194.98 | $257.04 | $302.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $38.90 | $51.29 | $60.26 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.30 | $34.67 | $39.81 |
Where Pennsylvania sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 46th of 51
$380
AK $1,479UT $302
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.