How much rates vary
Facilitymedian $3,020 · 10th to 90th $955 to $7,762Professionalmedian $1,413 · 10th to 90th $1,096 to $2,344
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 $1,047.13 Median $5,248.07 Typical High $8,709.64 | Facility | None | $1,047.13 | $5,248.07 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,348.96 | $1,621.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $933.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $758.58 | $933.25 | $1,122.02 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,570.40 | Professional | None | $2,511.89 | $2,511.89 | $2,570.40 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,737.80 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,737.80 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,348.96 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,818.38 | Professional | None | $2,630.27 | $2,630.27 | $2,818.38 |
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 $1,148.15 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,698.24 | $2,754.23 |
Martin's Point Setting Facility Modifier None Typical Low $1,148.15 Median $4,897.79 Typical High $8,709.64 | Facility | None | $1,148.15 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,348.96 | $1,621.81 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $933.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $758.58 | $933.25 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,445.44 | $2,691.53 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,096.48 Median $2,187.76 Typical High $4,466.84 | Facility | None | $1,096.48 | $2,187.76 | $4,466.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,148.15 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,513.56 | $2,511.89 |
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 $549.54 Median $676.08 Typical High $794.33 | Professional | 52 · Reduced service | $549.54 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $269.15 Typical High $323.59 | Professional | 53 · Discontinued | $218.78 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,000.00 Typical High $1,202.26 | Professional | 54 · Surgery only | $812.83 | $1,000.00 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $162.18 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $109.65 | $134.90 | $162.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $676.08 Typical High $794.33 | Professional | 52 · Reduced service | $549.54 | $676.08 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $269.15 Typical High $323.59 | Professional | 53 · Discontinued | $218.78 | $269.15 | $323.59 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,000.00 Typical High $1,202.26 | Professional | 54 · Surgery only | $812.83 | $1,000.00 | $1,202.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $162.18 | $204.17 | $239.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $109.65 | $134.90 | $162.18 |
Where Pennsylvania sits
The same service costs 5.2 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· 44th of 51
$1,479
AK $6,026TX $1,148
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.