How much rates vary
Facilitymedian $617 · 10th to 90th $155 to $3,802Professionalmedian $129 · 10th to 90th $62 to $234
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 $186.21 Median $2,344.23 Typical High $8,317.64 | Facility | None | $186.21 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $186.21 | Professional | None | $58.88 | $120.23 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $56.23 Typical High $93.33 | Professional | 52 · Reduced service | $29.51 | $56.23 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $22.39 Typical High $37.15 | Professional | 53 · Discontinued | $11.75 | $22.39 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $85.11 Typical High $138.04 | Professional | 54 · Surgery only | $43.65 | $85.11 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $16.98 Typical High $27.54 | Professional | 55 · Aftercare only | $8.71 | $16.98 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $11.22 Typical High $18.62 | Professional | 56 · Pre-op care only | $5.89 | $11.22 | $18.62 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $56,234.13 | Facility | None | $2,511.89 | $2,570.40 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $281.84 | Professional | None | $234.42 | $239.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $398.11 Typical High $851.14 | Facility | None | $154.88 | $398.11 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $125.89 Typical High $223.87 | Professional | None | $61.66 | $125.89 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $398.11 | Professional | None | $218.78 | $302.00 | $398.11 |
Geisinger Setting Facility Modifier None Typical Low $141.25 Median $177.83 Typical High $309.03 | Facility | None | $141.25 | $177.83 | $309.03 |
Geisinger Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $295.12 | Professional | None | $112.20 | $177.83 | $295.12 |
Martin's Point Setting Facility Modifier None Typical Low $426.58 Median $2,137.96 Typical High $7,244.36 | Facility | None | $426.58 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $58.88 Median $123.03 Typical High $186.21 | Professional | None | $58.88 | $123.03 | $186.21 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $58.88 Typical High $93.33 | Professional | 52 · Reduced service | $29.51 | $58.88 | $93.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $23.44 Typical High $37.15 | Professional | 53 · Discontinued | $11.75 | $23.44 | $37.15 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $87.10 Typical High $138.04 | Professional | 54 · Surgery only | $43.65 | $87.10 | $138.04 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $17.38 Typical High $27.54 | Professional | 55 · Aftercare only | $8.71 | $17.38 | $27.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $11.75 Typical High $18.62 | Professional | 56 · Pre-op care only | $5.89 | $11.75 | $18.62 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $275.42 | Professional | None | $169.82 | $177.83 | $275.42 |
UPMC Health Plan Setting Facility Modifier None Typical Low $102.33 Median $812.83 Typical High $1,862.09 | Facility | None | $102.33 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $63.10 Median $154.88 Typical High $162.18 | Professional | None | $63.10 | $154.88 | $162.18 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $2,818.38 | Facility | None | $416.87 | $724.44 | $2,818.38 |
United Setting Professional Modifier None Typical Low $56.23 Median $120.23 Typical High $186.21 | Professional | None | $56.23 | $120.23 | $186.21 |
2 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier PN · Off-campus dept, non-excepted Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | PN · Off-campus dept, non-excepted | $1,778.28 | $1,778.28 | $1,778.28 |
Highmark BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 78 · Unplanned return to OR | $61.66 | $61.66 | $61.66 |
Where Pennsylvania sits
The same service costs 3.7 times more in Alaska than in Washington, DC. 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
$129
AK $309DC $83.18
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.