How much rates vary
Facilitymedian $1,622 · 10th to 90th $575 to $5,012Professionalmedian $380 · 10th to 90th $309 to $513
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 $645.65 Median $3,090.30 Typical High $8,511.38 | Facility | None | $645.65 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $398.11 | Professional | None | $346.74 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $269.15 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $245.47 | $269.15 | $281.84 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $489.78 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $302.00 | $489.78 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,380.38 Typical High $2,290.87 | Facility | None | $478.63 | $1,380.38 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $724.44 | Professional | None | $309.03 | $363.08 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $831.76 | Professional | None | $446.68 | $602.56 | $831.76 |
Geisinger Setting Facility Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $3,019.95 | Facility | None | $1,380.38 | $1,737.80 | $3,019.95 |
Geisinger Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $660.69 | Professional | None | $309.03 | $389.05 | $660.69 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $8,317.64 | Facility | None | $724.44 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $398.11 | Professional | None | $346.74 | $389.05 | $398.11 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $269.15 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $245.47 | $269.15 | $281.84 |
Oscar Health Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $676.08 | Professional | None | $457.09 | $478.63 | $676.08 |
UPMC Health Plan Setting Facility Modifier None Typical Low $295.12 Median $1,288.25 Typical High $2,630.27 | Facility | None | $295.12 | $1,288.25 | $2,630.27 |
UPMC Health Plan Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $407.38 | Professional | None | $295.12 | $363.08 | $407.38 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,265.80 | Facility | None | $812.83 | $1,318.26 | $4,265.80 |
United Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $602.56 | Professional | None | $316.23 | $380.19 | $602.56 |
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 $173.78 Median $194.98 Typical High $199.53 | Professional | 52 · Reduced service | $173.78 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $79.43 | Professional | 53 · Discontinued | $69.18 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $288.40 Typical High $302.00 | Professional | 54 · Surgery only | $263.03 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $60.26 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $34.67 | $38.90 | $39.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $194.98 Typical High $199.53 | Professional | 52 · Reduced service | $173.78 | $194.98 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $79.43 | Professional | 53 · Discontinued | $69.18 | $77.62 | $79.43 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $288.40 Typical High $302.00 | Professional | 54 · Surgery only | $263.03 | $288.40 | $302.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $60.26 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $60.26 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $34.67 | $38.90 | $39.81 |
Where Pennsylvania sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$380
AK $1,549UT $302
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.