How much rates vary
Facilitymedian $794 · 10th to 90th $302 to $6,166Professionalmedian $676 · 10th to 90th $562 to $1,122
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 $724.44 Median $4,897.79 Typical High $8,511.38 | Facility | None | $724.44 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $724.44 | Professional | None | $630.96 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $501.19 |
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 $954.99 Median $1,071.52 Typical High $1,202.26 | Professional | None | $954.99 | $1,071.52 | $1,202.26 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $812.83 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $549.54 | $812.83 | $1,000.00 |
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 $549.54 Median $630.96 Typical High $1,258.93 | Professional | None | $549.54 | $630.96 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,479.11 | Professional | None | $794.33 | $1,071.52 | $1,479.11 |
Geisinger Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,174.90 | Professional | None | $562.34 | $691.83 | $1,174.90 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $3,801.89 Typical High $8,709.64 | Facility | None | $724.44 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $724.44 | Professional | None | $630.96 | $691.83 | $724.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $1,202.26 | Professional | None | $676.08 | $707.95 | $1,202.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $562.34 Median $1,778.28 Typical High $3,019.95 | Facility | None | $562.34 | $1,778.28 | $3,019.95 |
UPMC Health Plan Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | None | $562.34 | $660.69 | $660.69 |
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 $562.34 Median $676.08 Typical High $1,071.52 | Professional | None | $562.34 | $676.08 | $1,071.52 |
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 $316.23 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $524.81 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $107.15 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $72.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $346.74 | $363.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $138.04 | $144.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $524.81 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $524.81 | $537.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $107.15 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $107.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $72.44 |
Where Pennsylvania sits
The same service costs 5.4 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
$676
AK $2,512TX $468
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.