How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,072 to $8,318Professionalmedian $692 · 10th to 90th $646 to $1,000
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 $831.76 Median $5,495.41 Typical High $10,471.29 | Facility | None | $831.76 | $5,495.41 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $741.31 | Professional | None | $645.65 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $524.81 |
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $912.01 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $562.34 | $912.01 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $5,011.87 | Facility | None | $954.99 | $2,884.03 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,318.26 | Professional | None | $676.08 | $676.08 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,412.54 | Professional | None | $776.25 | $1,047.13 | $1,412.54 |
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 $741.31 Typical High $1,288.25 | Professional | None | $645.65 | $741.31 | $1,288.25 |
Martin's Point Setting Facility Modifier None Typical Low $977.24 Median $5,248.07 Typical High $10,964.78 | Facility | None | $977.24 | $5,248.07 | $10,964.78 |
Martin's Point Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $741.31 | Professional | None | $645.65 | $724.44 | $741.31 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $524.81 |
Oscar Health Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,412.54 | Professional | None | $776.25 | $812.83 | $1,412.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $691.83 Median $3,388.44 Typical High $6,606.93 | Facility | None | $691.83 | $3,388.44 | $6,606.93 |
UPMC Health Plan Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $630.96 Median $724.44 Typical High $1,148.15 | Professional | None | $630.96 | $724.44 | $1,148.15 |
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 $323.59 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $74.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $363.08 | $371.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $144.54 | $147.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $537.03 | $562.34 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $112.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $74.13 |
Where Pennsylvania sits
The same service costs 6.3 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· 46th of 51
$692
AK $2,884TX $457
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.