How much rates vary
Facilitymedian $851 · 10th to 90th $380 to $3,981Professionalmedian $263 · 10th to 90th $195 to $417
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 $380.19 Median $2,137.96 Typical High $8,317.64 | Facility | None | $380.19 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $331.13 | Professional | None | $194.98 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $173.78 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $131.83 | $173.78 | $199.53 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $56,234.13 | Facility | None | $2,630.27 | $3,019.95 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $489.78 | Professional | None | $389.05 | $407.38 | $489.78 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $346.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $213.80 | $346.74 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $645.65 Typical High $1,258.93 | Facility | None | $338.84 | $645.65 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $436.52 | Professional | None | $199.53 | $269.15 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $467.74 | Professional | None | $457.09 | $457.09 | $467.74 |
Geisinger Setting Facility Modifier None Typical Low $645.65 Median $794.33 Typical High $1,412.54 | Facility | None | $645.65 | $794.33 | $1,412.54 |
Geisinger Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $512.86 | Professional | None | $229.09 | $309.03 | $512.86 |
Highmark BCBS Setting Facility Modifier None Typical Low $891.25 Median $1,348.96 Typical High $5,011.87 | Facility | None | $891.25 | $1,348.96 | $5,011.87 |
Martin's Point Setting Facility Modifier None Typical Low $426.58 Median $2,137.96 Typical High $8,317.64 | Facility | None | $426.58 | $2,137.96 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $331.13 | Professional | None | $194.98 | $251.19 | $331.13 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $173.78 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $128.82 | $173.78 | $199.53 |
Oscar Health Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $588.84 | Professional | None | $245.47 | $263.03 | $588.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $213.80 Median $812.83 Typical High $1,862.09 | Facility | None | $213.80 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $263.03 | Professional | None | $194.98 | $218.78 | $263.03 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,467.37 | Facility | None | $416.87 | $724.44 | $3,467.37 |
United Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $457.09 | Professional | None | $194.98 | $275.42 | $457.09 |
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 $95.50 Median $125.89 Typical High $144.54 | Professional | 52 · Reduced service | $95.50 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $38.02 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $186.21 Typical High $213.80 | Professional | 54 · Surgery only | $141.25 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $37.15 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $19.05 | $25.12 | $28.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $125.89 Typical High $144.54 | Professional | 52 · Reduced service | $91.20 | $125.89 | $144.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $36.31 | $50.12 | $57.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $186.21 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $186.21 | $213.80 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $37.15 Typical High $42.66 | Professional | 55 · Aftercare only | $27.54 | $37.15 | $42.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $18.20 | $25.12 | $28.84 |
Where Pennsylvania sits
The same service costs 4.3 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· 45th of 51
$288
AK $1,000UT $234
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.