How much rates vary
Facilitymedian $1,514 · 10th to 90th $501 to $5,370Professionalmedian $501 · 10th to 90th $468 to $708
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 $676.08 Median $3,890.45 Typical High $8,317.64 | Facility | None | $676.08 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $537.03 | Professional | None | $467.74 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $371.54 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $56,234.13 | Facility | None | $3,981.07 | $4,365.16 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $660.69 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $407.38 | $660.69 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,445.44 Typical High $2,454.71 | Facility | None | $524.81 | $1,445.44 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $933.25 | Professional | None | $489.78 | $489.78 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $954.99 | Professional | None | $524.81 | $707.95 | $954.99 |
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 $446.68 Median $524.81 Typical High $891.25 | Professional | None | $446.68 | $524.81 | $891.25 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $537.03 | Professional | None | $467.74 | $524.81 | $537.03 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $1,023.29 | Professional | None | $575.44 | $602.56 | $1,023.29 |
UPMC Health Plan Setting Facility Modifier None Typical Low $478.63 Median $2,630.27 Typical High $5,128.61 | Facility | None | $478.63 | $2,630.27 | $5,128.61 |
UPMC Health Plan Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | None | $478.63 | $501.19 | $501.19 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $4,265.80 | Facility | None | $416.87 | $724.44 | $4,265.80 |
United Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $794.33 | Professional | None | $446.68 | $512.86 | $794.33 |
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 $234.42 Median $263.03 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $107.15 | Professional | 53 · Discontinued | $95.50 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $398.11 | Professional | 54 · Surgery only | $354.81 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $79.43 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $52.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $46.77 | $52.48 | $53.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $263.03 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $263.03 | $269.15 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $107.15 | Professional | 53 · Discontinued | $95.50 | $104.71 | $107.15 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $398.11 | Professional | 54 · Surgery only | $354.81 | $389.05 | $398.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $79.43 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $79.43 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $52.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $46.77 | $52.48 | $53.70 |
Where Pennsylvania sits
The same service costs 3.9 times more in Colorado than in Delaware. 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
CO $5,057DE $1,284
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.