How much rates vary
Facilitymedian $3,236 · 10th to 90th $525 to $13,183Professionalmedian $302 · 10th to 90th $269 to $479
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 $316.23 Median $3,801.89 Typical High $13,182.57 | Facility | None | $316.23 | $3,801.89 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $346.74 | Professional | None | $269.15 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $208.93 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $190.55 | $208.93 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $331.13 | Professional | None | $251.19 | $288.40 | $331.13 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $8,709.64 | Facility | None | $3,981.07 | $7,413.10 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $380.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $239.88 | $380.19 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,691.53 Typical High $4,897.79 | Facility | None | $524.81 | $2,691.53 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $537.03 | Professional | None | $269.15 | $281.84 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $524.81 | Professional | None | $309.03 | $416.87 | $524.81 |
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 $263.03 Median $309.03 Typical High $501.19 | Professional | None | $263.03 | $309.03 | $501.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $9,332.54 Typical High $20,892.96 | Facility | None | $3,467.37 | $9,332.54 | $20,892.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $426.58 | Professional | None | $288.40 | $426.58 | $426.58 |
Independence Blue Cross Setting Facility Modifier None Typical Low $5,495.41 Median $6,025.60 Typical High $9,332.54 | Facility | None | $5,495.41 | $6,025.60 | $9,332.54 |
Martin's Point Setting Facility Modifier None Typical Low $338.84 Median $3,890.45 Typical High $18,620.87 | Facility | None | $338.84 | $3,890.45 | $18,620.87 |
Martin's Point Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $338.84 | Professional | None | $269.15 | $302.00 | $338.84 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $208.93 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $190.55 | $208.93 | $213.80 |
Oscar Health Setting Facility Modifier None Typical Low $3,630.78 Median $4,897.79 Typical High $6,606.93 | Facility | None | $3,630.78 | $4,897.79 | $6,606.93 |
Oscar Health Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $575.44 | Professional | None | $354.81 | $371.54 | $575.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $288.40 Median $3,388.44 Typical High $6,606.93 | Facility | None | $288.40 | $3,388.44 | $6,606.93 |
UPMC Health Plan Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Professional | None | $288.40 | $288.40 | $389.05 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $6,025.60 | Facility | None | $812.83 | $1,318.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $457.09 | Professional | None | $251.19 | $288.40 | $457.09 |
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 $134.90 Median $147.91 Typical High $154.88 | Professional | 52 · Reduced service | $134.90 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $61.66 | Professional | 53 · Discontinued | $53.70 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $229.09 | Professional | 54 · Surgery only | $204.17 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $45.71 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $30.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $147.91 Typical High $154.88 | Professional | 52 · Reduced service | $134.90 | $147.91 | $154.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $61.66 | Professional | 53 · Discontinued | $53.70 | $60.26 | $61.66 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $229.09 | Professional | 54 · Surgery only | $204.17 | $223.87 | $229.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $45.71 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $45.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $30.90 |
Where Pennsylvania sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 42nd of 51
$302
AK $1,202UT $219
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.