How much rates vary
Facilitymedian $2,188 · 10th to 90th $724 to $6,457Professionalmedian $437 · 10th to 90th $363 to $776
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 $707.95 Median $4,786.30 Typical High $8,511.38 | Facility | None | $707.95 | $4,786.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $436.52 | Professional | None | $380.19 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $295.12 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $269.15 | $295.12 | $309.03 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $8,709.64 | Facility | None | $3,981.07 | $7,413.10 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $851.14 | Professional | None | $407.38 | $660.69 | $851.14 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $977.24 Typical High $1,288.25 | Professional | 50 · Both sides | $616.60 | $977.24 | $1,288.25 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $537.03 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $331.13 | $537.03 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,698.24 Typical High $2,884.03 | Facility | None | $616.60 | $1,698.24 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $794.33 | Professional | None | $354.81 | $398.11 | $794.33 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $891.25 | Professional | None | $478.63 | $630.96 | $891.25 |
Geisinger Setting Facility Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,715.35 | Facility | None | $1,698.24 | $2,137.96 | $3,715.35 |
Geisinger Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $741.31 | Professional | None | $363.08 | $426.58 | $741.31 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,025.60 Typical High $16,982.44 | Facility | None | $4,677.35 | $6,025.60 | $16,982.44 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $4,570.88 Typical High $8,511.38 | Facility | None | $724.44 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $436.52 | Professional | None | $380.19 | $426.58 | $436.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $295.12 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $269.15 | $295.12 | $309.03 |
Oscar Health Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $741.31 | Professional | None | $457.09 | $478.63 | $741.31 |
UPMC Health Plan Setting Facility Modifier None Typical Low $398.11 Median $3,388.44 Typical High $6,606.93 | Facility | None | $398.11 | $3,388.44 | $6,606.93 |
UPMC Health Plan Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $467.74 | Professional | None | $398.11 | $407.38 | $467.74 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $660.69 | Professional | None | $354.81 | $416.87 | $660.69 |
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 $190.55 Median $213.80 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $75.86 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $316.23 Typical High $331.13 | Professional | 54 · Surgery only | $288.40 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $63.10 Typical High $66.07 | Professional | 55 · Aftercare only | $57.54 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $213.80 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $213.80 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $75.86 | $85.11 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $316.23 Typical High $331.13 | Professional | 54 · Surgery only | $288.40 | $316.23 | $331.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $63.10 Typical High $66.07 | Professional | 55 · Aftercare only | $57.54 | $63.10 | $66.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $43.65 |
Where Pennsylvania sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 38th of 51
$437
AK $1,660UT $295
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.