How much rates vary
Facilitymedian $891 · 10th to 90th $324 to $8,511Professionalmedian $794 · 10th to 90th $692 to $1,288
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 $831.76 Median $6,165.95 Typical High $10,715.19 | Facility | None | $831.76 | $6,165.95 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $831.76 | Professional | None | $724.44 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $575.44 |
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,000.00 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $630.96 | $1,000.00 | $1,230.27 |
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 $691.83 Median $758.58 Typical High $1,513.56 | Professional | None | $691.83 | $758.58 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,659.59 | Professional | None | $870.96 | $1,174.90 | $1,659.59 |
Geisinger Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,412.54 | Professional | None | $707.95 | $812.83 | $1,412.54 |
Martin's Point Setting Facility Modifier None Typical Low $1,023.29 Median $5,495.41 Typical High $11,220.18 | Facility | None | $1,023.29 | $5,495.41 | $11,220.18 |
Martin's Point Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $831.76 | Professional | None | $724.44 | $812.83 | $831.76 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $575.44 |
Oscar Health Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,479.11 | Professional | None | $912.01 | $954.99 | $1,479.11 |
UPMC Health Plan Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $1,288.25 | Facility | None | $758.58 | $1,288.25 | $1,288.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,288.25 | Professional | None | $758.58 | $776.25 | $1,288.25 |
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 $691.83 Median $794.33 Typical High $1,258.93 | Professional | None | $691.83 | $794.33 | $1,258.93 |
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 $363.08 Median $407.38 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $83.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $407.38 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $407.38 | $416.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $162.18 | $165.96 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $602.56 | $616.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $125.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $83.18 |
Where Pennsylvania sits
The same service costs 5.9 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· 43rd of 51
$794
AK $3,162TX $537
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.