How much rates vary
Facilitymedian $1,698 · 10th to 90th $661 to $5,495Professionalmedian $617 · 10th to 90th $501 to $851
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 $676.08 Median $3,890.45 Typical High $8,317.64 | Facility | None | $676.08 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $660.69 | Professional | None | $588.84 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $467.74 |
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 $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $794.33 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $501.19 | $794.33 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,380.38 Typical High $2,344.23 | Facility | None | $501.19 | $1,380.38 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,202.26 | Professional | None | $501.19 | $602.56 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,380.38 | Professional | None | $741.31 | $977.24 | $1,380.38 |
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 $501.19 Median $645.65 Typical High $1,071.52 | Professional | None | $501.19 | $645.65 | $1,071.52 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $660.69 | Professional | None | $588.84 | $645.65 | $660.69 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $467.74 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $1,096.48 | Professional | None | $489.78 | $512.86 | $1,096.48 |
UPMC Health Plan Setting Facility Modifier None Typical Low $478.63 Median $1,737.80 Typical High $3,388.44 | Facility | None | $478.63 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $616.60 | Professional | None | $478.63 | $602.56 | $616.60 |
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 $524.81 Median $630.96 Typical High $1,000.00 | Professional | None | $524.81 | $630.96 | $1,000.00 |
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 $288.40 Median $323.59 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $501.19 | Professional | 54 · Surgery only | $436.52 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $100.00 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $66.07 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $323.59 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $323.59 | $331.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $128.82 | $134.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $501.19 | Professional | 54 · Surgery only | $436.52 | $478.63 | $501.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $100.00 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $100.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $64.57 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $64.57 | $66.07 |
Where Pennsylvania sits
The same service costs 5.6 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
$631
AK $2,512TX $447
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.