How much rates vary
Facilitymedian $1,738 · 10th to 90th $661 to $5,754Professionalmedian $832 · 10th to 90th $692 to $1,514
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 $3,801.89 Typical High $8,511.38 | Facility | None | $724.44 | $3,801.89 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $831.76 | Professional | None | $691.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $478.63 | $588.84 | $588.84 |
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 $776.25 Median $1,230.27 Typical High $1,548.82 | Professional | None | $776.25 | $1,230.27 | $1,548.82 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,023.29 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $645.65 | $1,023.29 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $2,754.23 | Facility | None | $501.19 | $1,659.59 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,479.11 | Professional | None | $724.44 | $831.76 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | None | $1,122.02 | $1,122.02 | $1,174.90 |
Geisinger Setting Facility Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $3,630.78 | Facility | None | $1,659.59 | $2,089.30 | $3,630.78 |
Geisinger Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,513.56 | Professional | None | $724.44 | $954.99 | $1,513.56 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $8,709.64 | Facility | None | $831.76 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $831.76 | Professional | None | $691.83 | $831.76 | $831.76 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $575.44 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $478.63 | $575.44 | $588.84 |
Oscar Health Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,698.24 | Professional | None | $891.25 | $977.24 | $1,698.24 |
UPMC Health Plan Setting Facility Modifier None Typical Low $758.58 Median $812.83 Typical High $812.83 | Facility | None | $758.58 | $812.83 | $812.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $812.83 | Professional | None | $758.58 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,897.79 | Facility | None | $812.83 | $1,318.26 | $4,897.79 |
United Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,584.89 | Professional | None | $741.31 | $912.01 | $1,584.89 |
11 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 $346.74 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $138.04 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $512.86 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $69.18 | $83.18 | $83.18 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,862.09 Typical High $2,290.87 | Professional | 50 · Both sides | $1,174.90 | $1,862.09 | $2,290.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $138.04 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $630.96 | Professional | 54 · Surgery only | $512.86 | $616.60 | $630.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $69.18 | $83.18 | $83.18 |
Where Pennsylvania sits
The same service costs 5.8 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· 45th of 51
$832
AK $3,162UT $550
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.