How much rates vary
Facilitymedian $832 · 10th to 90th $417 to $4,898Professionalmedian $562 · 10th to 90th $501 to $933
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 $602.56 Median $4,897.79 Typical High $8,511.38 | Facility | None | $602.56 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $602.56 | Professional | None | $524.81 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $426.58 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $56,234.13 | Facility | None | $2,630.27 | $3,019.95 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $724.44 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $457.09 | $724.44 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $645.65 Typical High $1,258.93 | Facility | None | $354.81 | $645.65 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $1,047.13 | Professional | None | $501.19 | $549.54 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,230.27 | Professional | None | $660.69 | $870.96 | $1,230.27 |
Geisinger Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $1,071.52 | Professional | None | $512.86 | $588.84 | $1,071.52 |
Martin's Point Setting Facility Modifier None Typical Low $602.56 Median $3,801.89 Typical High $8,709.64 | Facility | None | $602.56 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $602.56 | Professional | None | $524.81 | $588.84 | $602.56 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $426.58 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,047.13 | Professional | None | $691.83 | $724.44 | $1,047.13 |
UPMC Health Plan Setting Facility Modifier None Typical Low $549.54 Median $2,691.53 Typical High $4,570.88 | Facility | None | $549.54 | $2,691.53 | $4,570.88 |
UPMC Health Plan Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $630.96 | Professional | None | $549.54 | $562.34 | $630.96 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,467.37 | Facility | None | $416.87 | $724.44 | $3,467.37 |
United Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $912.01 | Professional | None | $501.19 | $575.44 | $912.01 |
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 $263.03 Median $295.12 Typical High $302.00 | Professional | 52 · Reduced service | $263.03 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $120.23 | Professional | 53 · Discontinued | $107.15 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $58.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $52.48 | $58.88 | $60.26 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $295.12 Typical High $302.00 | Professional | 52 · Reduced service | $263.03 | $295.12 | $302.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $120.23 | Professional | 53 · Discontinued | $107.15 | $117.49 | $120.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $436.52 | $457.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $91.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $58.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $52.48 | $58.88 | $60.26 |
Where Pennsylvania sits
The same service costs 5.5 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· 42nd of 51
$575
AK $2,188TX $398
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.