How much rates vary
Facilitymedian $1,479 · 10th to 90th $427 to $4,365Professionalmedian $447 · 10th to 90th $389 to $617
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 $537.03 Median $2,344.23 Typical High $8,317.64 | Facility | None | $537.03 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $489.78 | Professional | None | $426.58 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $323.59 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $295.12 | $323.59 | $346.74 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $56,234.13 | Facility | None | $3,981.07 | $4,365.16 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $575.44 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $363.08 | $575.44 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,380.38 Typical High $2,398.83 | Facility | None | $338.84 | $1,380.38 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $812.83 | Professional | None | $407.38 | $426.58 | $812.83 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $933.25 | Professional | None | $512.86 | $707.95 | $933.25 |
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 $407.38 Median $467.74 Typical High $812.83 | Professional | None | $407.38 | $467.74 | $812.83 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $7,244.36 | Facility | None | $588.84 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $489.78 | Professional | None | $426.58 | $467.74 | $489.78 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $323.59 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $295.12 | $323.59 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $831.76 | Professional | None | $346.74 | $363.08 | $831.76 |
UPMC Health Plan Setting Facility Modifier None Typical Low $416.87 Median $1,122.02 Typical High $2,238.72 | Facility | None | $416.87 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $446.68 | Professional | None | $416.87 | $436.52 | $446.68 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $4,265.80 | Facility | None | $416.87 | $724.44 | $4,265.80 |
United Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $707.95 | Professional | None | $363.08 | $436.52 | $707.95 |
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 $208.93 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $371.54 | Professional | 54 · Surgery only | $316.23 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $48.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $234.42 | $245.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $93.33 | $97.72 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $371.54 | Professional | 54 · Surgery only | $316.23 | $346.74 | $371.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $74.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $48.98 |
Where Pennsylvania sits
The same service costs 6.2 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· 41st of 51
$447
AK $1,862TX $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.