How much rates vary
Facilitymedian $3,020 · 10th to 90th $832 to $7,413Professionalmedian $871 · 10th to 90th $759 to $1,380
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 $870.96 Median $4,897.79 Typical High $8,511.38 | Facility | None | $870.96 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $870.96 | Professional | None | $758.58 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $602.56 |
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 $1,174.90 Median $1,318.26 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,318.26 | $1,445.44 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,071.52 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $660.69 | $1,071.52 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,818.38 Typical High $4,897.79 | Facility | None | $616.60 | $2,818.38 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,548.82 | Professional | None | $794.33 | $794.33 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,548.82 | Professional | None | $831.76 | $1,148.15 | $1,548.82 |
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 $724.44 Median $870.96 Typical High $1,445.44 | Professional | None | $724.44 | $870.96 | $1,445.44 |
Martin's Point Setting Facility Modifier None Typical Low $870.96 Median $4,570.88 Typical High $8,511.38 | Facility | None | $870.96 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $870.96 | Professional | None | $758.58 | $851.14 | $870.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,659.59 | Professional | None | $891.25 | $954.99 | $1,659.59 |
UPMC Health Plan Setting Facility Modifier None Typical Low $812.83 Median $2,137.96 Typical High $4,265.80 | Facility | None | $812.83 | $2,137.96 | $4,265.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | None | $812.83 | $812.83 | $831.76 |
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 $724.44 Median $831.76 Typical High $1,288.25 | Professional | None | $724.44 | $831.76 | $1,288.25 |
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 $380.19 Median $426.58 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $645.65 | Professional | 54 · Surgery only | $575.44 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $87.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $426.58 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $426.58 | $436.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $169.82 | $173.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $645.65 | Professional | 54 · Surgery only | $575.44 | $630.96 | $645.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $87.10 |
Where Pennsylvania sits
The same service costs 6.5 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· 38th of 51
$871
AK $3,311TX $513
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.