How much rates vary
Facilitymedian $3,020 · 10th to 90th $955 to $7,762Professionalmedian $1,413 · 10th to 90th $1,148 to $2,291
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 $1,122.02 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,380.38 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $794.33 | $977.24 | $1,096.48 |
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 $1,905.46 Median $1,905.46 Typical High $56,234.13 | Professional | None | $1,905.46 | $1,905.46 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,905.46 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,905.46 | $2,344.23 |
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 $1,174.90 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,412.54 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,511.89 | Professional | None | $2,398.83 | $2,398.83 | $2,511.89 |
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 $1,288.25 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,659.59 | $2,884.03 |
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 $1,122.02 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,380.38 | $1,584.89 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $794.33 | $977.24 | $1,096.48 |
Oscar Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,659.59 | $2,884.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,148.15 Median $2,187.76 Typical High $4,365.16 | Facility | None | $1,148.15 | $2,187.76 | $4,365.16 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,174.90 | $1,445.44 |
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 $1,122.02 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,584.89 | $2,570.40 |
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 $562.34 Median $691.83 Typical High $794.33 | Professional | 52 · Reduced service | $562.34 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $223.87 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $851.14 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $169.82 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $138.04 Typical High $158.49 | Professional | 56 · Pre-op care only | $112.20 | $138.04 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $691.83 Typical High $794.33 | Professional | 52 · Reduced service | $562.34 | $691.83 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $223.87 | $275.42 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $851.14 | $1,047.13 | $1,174.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $169.82 | $208.93 | $234.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $138.04 Typical High $158.49 | Professional | 56 · Pre-op care only | $112.20 | $138.04 | $158.49 |
Where Pennsylvania sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $12,311KY $3,892
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.