How much rates vary
Facilitymedian $2,188 · 10th to 90th $741 to $6,457Professionalmedian $646 · 10th to 90th $562 to $1,072
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 $812.83 Median $4,897.79 Typical High $8,511.38 | Facility | None | $812.83 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $645.65 | Professional | None | $562.34 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $446.68 |
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 $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,000.00 | $1,071.52 | $1,071.52 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $794.33 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $489.78 | $794.33 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,445.44 Typical High $2,818.38 | Facility | None | $616.60 | $1,445.44 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,148.15 | Professional | None | $588.84 | $588.84 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,174.90 | Professional | None | $630.96 | $851.14 | $1,174.90 |
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 $537.03 Median $630.96 Typical High $1,096.48 | Professional | None | $537.03 | $630.96 | $1,096.48 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $4,570.88 Typical High $8,511.38 | Facility | None | $831.76 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $645.65 | Professional | None | $562.34 | $630.96 | $645.65 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $446.68 |
Oscar Health Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $1,258.93 | Professional | None | $724.44 | $758.58 | $1,258.93 |
UPMC Health Plan Setting Facility Modifier None Typical Low $602.56 Median $2,137.96 Typical High $4,168.69 | Facility | None | $602.56 | $2,137.96 | $4,168.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $691.83 | Professional | None | $602.56 | $602.56 | $691.83 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,309.57 | Facility | None | $1,380.38 | $2,398.83 | $6,309.57 |
United Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $954.99 | Professional | None | $537.03 | $616.60 | $954.99 |
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 $281.84 Median $316.23 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $128.82 | Professional | 53 · Discontinued | $112.20 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $478.63 | Professional | 54 · Surgery only | $426.58 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $97.72 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $64.57 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $316.23 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $316.23 | $323.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $128.82 | Professional | 53 · Discontinued | $112.20 | $125.89 | $128.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $478.63 | Professional | 54 · Surgery only | $426.58 | $467.74 | $478.63 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $97.72 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $97.72 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $64.57 |
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· 41st of 51
$646
AK $2,455TX $380
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.