How much rates vary
Facilitymedian $3,311 · 10th to 90th $813 to $8,511Professionalmedian $776 · 10th to 90th $692 to $1,047
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 $5,495.41 Typical High $8,709.64 | Facility | None | $831.76 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $812.83 | Professional | None | $724.44 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $575.44 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $15,848.93 Typical High $56,234.13 | Facility | None | $3,981.07 | $15,848.93 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,122.02 | Professional | None | $676.08 | $676.08 | $1,122.02 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $933.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $588.84 | $933.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,818.38 Typical High $4,897.79 | Facility | None | $691.83 | $2,818.38 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,513.56 | Professional | None | $691.83 | $741.31 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,659.59 | Professional | None | $870.96 | $1,174.90 | $1,659.59 |
Geisinger Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,412.54 | Professional | None | $707.95 | $794.33 | $1,412.54 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $8,709.64 | Facility | None | $912.01 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $812.83 | Professional | None | $724.44 | $794.33 | $812.83 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $575.44 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,445.44 | Professional | None | $851.14 | $870.96 | $1,445.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $758.58 Median $977.24 Typical High $977.24 | Facility | None | $758.58 | $977.24 | $977.24 |
UPMC Health Plan Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $977.24 | Professional | None | $758.58 | $758.58 | $977.24 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $8,511.38 | Facility | None | $1,698.24 | $3,235.94 | $8,511.38 |
United Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,230.27 | Professional | None | $676.08 | $776.25 | $1,230.27 |
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 $363.08 Median $398.11 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $144.54 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $81.28 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $398.11 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $398.11 | $407.38 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $144.54 | $158.49 | $162.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $602.56 | $616.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $123.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $81.28 |
Where Pennsylvania sits
The same service costs 25.1 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· 40th of 51
$794
AK $3,090TX $123
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.