How much rates vary
Facilitymedian $2,570 · 10th to 90th $661 to $6,607Professionalmedian $871 · 10th to 90th $631 to $1,479
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 $724.44 Median $3,801.89 Typical High $8,317.64 | Facility | None | $724.44 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,000.00 | Professional | None | $630.96 | $794.33 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $537.03 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $436.52 | $537.03 | $691.83 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $812.83 Median $1,348.96 Typical High $1,659.59 | Professional | None | $812.83 | $1,348.96 | $1,659.59 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,071.52 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $660.69 | $1,071.52 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $4,897.79 | Facility | None | $501.19 | $2,691.53 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,479.11 | Professional | None | $588.84 | $812.83 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,445.44 | Professional | None | $1,348.96 | $1,348.96 | $1,445.44 |
Geisinger Setting Facility Modifier None Typical Low $2,951.21 Median $3,630.78 Typical High $6,456.54 | Facility | None | $2,951.21 | $3,630.78 | $6,456.54 |
Geisinger Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,513.56 | Professional | None | $645.65 | $912.01 | $1,513.56 |
Highmark BCBS Setting Facility Modifier None Typical Low $28,183.83 Median $28,183.83 Typical High $28,183.83 | Facility | None | $28,183.83 | $28,183.83 | $28,183.83 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,715.35 Typical High $8,317.64 | Facility | None | $776.25 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,000.00 | Professional | None | $630.96 | $794.33 | $1,000.00 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $537.03 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $436.52 | $537.03 | $691.83 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,621.81 | Professional | None | $691.83 | $812.83 | $1,621.81 |
UPMC Health Plan Setting Facility Modifier None Typical Low $549.54 Median $1,513.56 Typical High $3,019.95 | Facility | None | $549.54 | $1,513.56 | $3,019.95 |
UPMC Health Plan Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $912.01 | Professional | None | $549.54 | $660.69 | $912.01 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $6,025.60 | Facility | None | $812.83 | $1,318.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,479.11 | Professional | None | $602.56 | $891.25 | $1,479.11 |
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 $316.23 Median $389.05 Typical High $501.19 | Professional | 52 · Reduced service | $316.23 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $154.88 Typical High $199.53 | Professional | 53 · Discontinued | $125.89 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $575.44 Typical High $741.31 | Professional | 54 · Surgery only | $467.74 | $575.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $114.82 Typical High $151.36 | Professional | 55 · Aftercare only | $93.33 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $77.62 Typical High $100.00 | Professional | 56 · Pre-op care only | $63.10 | $77.62 | $100.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $380.19 Typical High $501.19 | Professional | 52 · Reduced service | $316.23 | $380.19 | $501.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $154.88 Typical High $199.53 | Professional | 53 · Discontinued | $125.89 | $154.88 | $199.53 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $575.44 Typical High $741.31 | Professional | 54 · Surgery only | $467.74 | $575.44 | $741.31 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $114.82 Typical High $151.36 | Professional | 55 · Aftercare only | $93.33 | $114.82 | $151.36 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $77.62 Typical High $100.00 | Professional | 56 · Pre-op care only | $63.10 | $77.62 | $100.00 |
Where Pennsylvania sits
The same service costs 5.2 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· 42nd of 51
$912
AK $3,548UT $676
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.