How much rates vary
Facilitymedian $1,445 · 10th to 90th $661 to $5,495Professionalmedian $1,072 · 10th to 90th $891 to $1,738
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 $891.25 Median $3,235.94 Typical High $8,511.38 | Facility | None | $891.25 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | None | $891.25 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $758.58 | $758.58 |
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 $1,584.89 Median $1,584.89 Typical High $56,234.13 | Professional | None | $1,584.89 | $1,584.89 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,348.96 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $831.76 | $1,348.96 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,000.00 Typical High $2,041.74 | Facility | None | $489.78 | $1,000.00 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,949.84 | Professional | None | $954.99 | $1,071.52 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,445.44 | $1,445.44 | $1,548.82 |
Geisinger Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,995.26 | Professional | None | $933.25 | $1,230.27 | $1,995.26 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $8,317.64 | Facility | None | $954.99 | $2,818.38 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | None | $891.25 | $1,071.52 | $1,071.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $758.58 | $758.58 |
Oscar Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,258.93 | $2,137.96 |
UPMC Health Plan Setting Facility Modifier None Typical Low $977.24 Median $1,548.82 Typical High $2,630.27 | Facility | None | $977.24 | $1,548.82 | $2,630.27 |
UPMC Health Plan Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,047.13 | Professional | None | $977.24 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $3,981.07 | Facility | None | $812.83 | $1,318.26 | $3,981.07 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $2,041.74 | Professional | None | $954.99 | $1,174.90 | $2,041.74 |
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 $446.68 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $446.68 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $177.83 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $107.15 | $107.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $446.68 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $177.83 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $812.83 | $812.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $162.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $107.15 | $107.15 |
Where Pennsylvania sits
The same service costs 5.9 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· 43rd of 51
$1,072
AK $4,074UT $692
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.