How much rates vary
Facilitymedian $1,660 · 10th to 90th $603 to $5,012Professionalmedian $575 · 10th to 90th $447 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 $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 $537.03 Median $588.84 Typical High $616.60 | Professional | None | $537.03 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $426.58 |
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 $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 $467.74 Median $724.44 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $467.74 | $724.44 | $851.14 |
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 $446.68 Median $549.54 Typical High $1,096.48 | Professional | None | $446.68 | $549.54 | $1,096.48 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,288.25 | Professional | None | $676.08 | $912.01 | $1,288.25 |
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 $446.68 Median $602.56 Typical High $977.24 | Professional | None | $446.68 | $602.56 | $977.24 |
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 $537.03 Median $588.84 Typical High $616.60 | Professional | None | $537.03 | $588.84 | $616.60 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $426.58 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $1,023.29 | Professional | None | $562.34 | $588.84 | $1,023.29 |
UPMC Health Plan Setting Facility Modifier None Typical Low $549.54 Median $1,513.56 Typical High $2,951.21 | Facility | None | $549.54 | $1,513.56 | $2,951.21 |
UPMC Health Plan Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | None | $549.54 | $562.34 | $562.34 |
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 $457.09 Median $575.44 Typical High $891.25 | Professional | None | $457.09 | $575.44 | $891.25 |
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 $269.15 Median $295.12 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $61.66 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $295.12 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $295.12 | $309.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $117.49 | $123.03 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $446.68 | $457.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $91.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $61.66 |
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· 41st of 51
$575
AK $2,344TX $427
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.