How much rates vary
Facilitymedian $794 · 10th to 90th $240 to $6,310Professionalmedian $1,000 · 10th to 90th $851 to $1,585
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 $954.99 Median $1,047.13 Typical High $1,096.48 | Professional | None | $954.99 | $1,047.13 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $758.58 |
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 $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,737.80 | $1,737.80 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,288.25 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $812.83 | $1,288.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $676.08 Typical High $2,290.87 | Facility | None | $120.23 | $676.08 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,949.84 | Professional | None | $851.14 | $954.99 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,584.89 | $2,187.76 |
Geisinger Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,778.28 | Professional | None | $831.76 | $1,047.13 | $1,778.28 |
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 $954.99 Median $1,047.13 Typical High $1,096.48 | Professional | None | $954.99 | $1,047.13 | $1,096.48 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $758.58 |
Oscar Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,071.52 | $1,862.09 |
UPMC Health Plan Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
UPMC Health Plan Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
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 $851.14 Median $1,023.29 Typical High $1,621.81 | Professional | None | $851.14 | $1,023.29 | $1,621.81 |
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 $467.74 Median $524.81 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $208.93 Typical High $218.78 | Professional | 53 · Discontinued | $190.55 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $158.49 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $109.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $524.81 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $524.81 | $537.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $208.93 Typical High $218.78 | Professional | 53 · Discontinued | $190.55 | $208.93 | $218.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $776.25 | $812.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $158.49 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $158.49 | $162.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $109.65 |
Where Pennsylvania sits
The same service costs 4.9 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
$1,000
AK $3,548TX $724
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.