How much rates vary
Facilitymedian $229 · 10th to 90th $78 to $3,467Professionalmedian $407 · 10th to 90th $355 to $603
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 $537.03 Median $2,454.71 Typical High $8,317.64 | Facility | None | $537.03 | $2,454.71 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $436.52 | Professional | None | $380.19 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $295.12 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $269.15 | $295.12 | $302.00 |
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 $436.52 Median $645.65 Typical High $645.65 | Professional | None | $436.52 | $645.65 | $645.65 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $537.03 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $331.13 | $537.03 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $144.54 Typical High $275.42 | Facility | None | $50.12 | $144.54 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $758.58 | Professional | None | $354.81 | $398.11 | $758.58 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $794.33 | Professional | None | $436.52 | $588.84 | $794.33 |
Geisinger Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $275.42 | Facility | None | $125.89 | $158.49 | $275.42 |
Geisinger Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $724.44 | Professional | None | $363.08 | $407.38 | $724.44 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $7,244.36 | Facility | None | $588.84 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $436.52 | Professional | None | $380.19 | $426.58 | $436.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $295.12 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $269.15 | $295.12 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $776.25 | Professional | None | $389.05 | $407.38 | $776.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $691.83 | Facility | None | $251.19 | $407.38 | $691.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | None | $363.08 | $407.38 | $407.38 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $645.65 | Professional | None | $346.74 | $407.38 | $645.65 |
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 $190.55 Median $213.80 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $75.86 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $316.23 Typical High $323.59 | Professional | 54 · Surgery only | $288.40 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $63.10 Typical High $64.57 | Professional | 55 · Aftercare only | $57.54 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $213.80 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $213.80 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $75.86 | $85.11 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $316.23 Typical High $323.59 | Professional | 54 · Surgery only | $288.40 | $316.23 | $323.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $63.10 Typical High $64.57 | Professional | 55 · Aftercare only | $57.54 | $63.10 | $64.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $43.65 |
Where Pennsylvania sits
The same service costs 4.2 times more in Wyoming 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
$407
WY $1,288UT $309
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.