How much rates vary
Facilitymedian $794 · 10th to 90th $240 to $6,310Professionalmedian $1,259 · 10th to 90th $1,072 to $2,344
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 $831.76 Median $4,897.79 Typical High $8,511.38 | Facility | None | $831.76 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,230.27 | Professional | None | $1,071.52 | $1,202.26 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $851.14 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,949.84 | $2,630.27 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,584.89 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $933.25 | $1,584.89 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $645.65 Typical High $2,290.87 | Facility | None | $380.19 | $645.65 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,380.38 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,737.80 | $2,398.83 |
Geisinger Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,288.25 | $2,089.30 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $8,709.64 | Facility | None | $831.76 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,230.27 | Professional | None | $1,071.52 | $1,202.26 | $1,230.27 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $891.25 | $912.01 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $851.14 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,258.93 | $2,238.72 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,122.02 | $1,258.93 | $1,258.93 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,258.93 | Professional | None | $1,122.02 | $1,148.15 | $1,258.93 |
United Setting Facility Modifier None Typical Low $199.53 Median $562.34 Typical High $4,265.80 | Facility | None | $199.53 | $562.34 | $4,265.80 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,202.26 | $1,905.46 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier GC · Resident with teaching physician Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | GC · Resident with teaching physician | $1,258.93 | $1,258.93 | $1,258.93 |
Where Pennsylvania sits
The same service costs 6.4 times more in Colorado than in Maryland. 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 $11,549MD $1,793
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.