How much rates vary
Facilitymedian $447 · 10th to 90th $100 to $3,311Professionalmedian $166 · 10th to 90th $151 to $240
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 $169.82 Median $1,584.89 Typical High $6,606.93 | Facility | None | $169.82 | $1,584.89 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $181.97 | Professional | None | $151.36 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $117.49 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $104.71 | $117.49 | $120.23 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $234.42 | Professional | None | $194.98 | $234.42 | $234.42 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $204.17 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $128.82 | $204.17 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $426.58 Typical High $645.65 | Facility | None | $302.00 | $426.58 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $323.59 | Professional | None | $154.88 | $158.49 | $323.59 |
Emblem Health Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $316.23 | Professional | None | $173.78 | $234.42 | $316.23 |
Geisinger Setting Facility Modifier None Typical Low $288.40 Median $354.81 Typical High $630.96 | Facility | None | $288.40 | $354.81 | $630.96 |
Geisinger Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $295.12 | Professional | None | $147.91 | $173.78 | $295.12 |
Highmark BCBS Setting Facility Modifier None Typical Low $933.25 Median $1,778.28 Typical High $9,549.93 | Facility | None | $933.25 | $1,778.28 | $9,549.93 |
Martin's Point Setting Facility Modifier None Typical Low $169.82 Median $1,584.89 Typical High $6,165.95 | Facility | None | $169.82 | $1,584.89 | $6,165.95 |
Martin's Point Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $177.83 | Professional | None | $151.36 | $165.96 | $177.83 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $117.49 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $104.71 | $117.49 | $120.23 |
Oscar Health Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $338.84 | Professional | None | $190.55 | $204.17 | $338.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $158.49 Median $1,122.02 Typical High $2,238.72 | Facility | None | $158.49 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $158.49 Median $162.18 Typical High $165.96 | Professional | None | $158.49 | $162.18 | $165.96 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,698.24 | Facility | None | $77.62 | $158.49 | $1,698.24 |
United Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $263.03 | Professional | None | $144.54 | $165.96 | $263.03 |
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 $75.86 Median $83.18 Typical High $85.11 | Professional | 52 · Reduced service | $75.86 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.11 Typical High $33.88 | Professional | 53 · Discontinued | $30.20 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $125.89 Typical High $128.82 | Professional | 54 · Surgery only | $112.20 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.12 Typical High $25.70 | Professional | 55 · Aftercare only | $22.39 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.60 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.14 | $16.60 | $16.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $83.18 Typical High $85.11 | Professional | 52 · Reduced service | $75.86 | $83.18 | $85.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.11 Typical High $33.88 | Professional | 53 · Discontinued | $30.20 | $33.11 | $33.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $125.89 Typical High $128.82 | Professional | 54 · Surgery only | $112.20 | $125.89 | $128.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.12 Typical High $25.70 | Professional | 55 · Aftercare only | $22.39 | $25.12 | $25.70 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.60 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.14 | $16.60 | $16.98 |
Where Pennsylvania sits
The same service costs 6.2 times more in New York than in Florida. 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.
Physician feeFacility fee
NY $2,729FL $440
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.