How much rates vary
Facilitymedian $2,570 · 10th to 90th $617 to $7,943Professionalmedian $617 · 10th to 90th $513 to $1,000
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 $5,495.41 Typical High $8,709.64 | Facility | None | $831.76 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $691.83 | Professional | None | $512.86 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $436.52 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $56,234.13 | Professional | None | $912.01 | $912.01 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $776.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $489.78 | $776.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $3,715.35 | Facility | None | $501.19 | $2,137.96 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $1,122.02 | Professional | None | $549.54 | $616.60 | $1,122.02 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $891.25 | Professional | None | $831.76 | $831.76 | $891.25 |
Geisinger Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,174.90 | Professional | None | $537.03 | $724.44 | $1,174.90 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $8,709.64 | Facility | None | $912.01 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $691.83 | Professional | None | $512.86 | $616.60 | $691.83 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $436.52 |
Oscar Health Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,258.93 | Professional | None | $660.69 | $831.76 | $1,258.93 |
UPMC Health Plan Setting Facility Modifier None Typical Low $562.34 Median $2,187.76 Typical High $3,467.37 | Facility | None | $562.34 | $2,187.76 | $3,467.37 |
UPMC Health Plan Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $831.76 | Professional | None | $562.34 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,174.90 | Professional | None | $549.54 | $676.08 | $1,174.90 |
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 $257.04 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $257.04 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $102.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $389.05 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $61.66 | $61.66 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $257.04 | $309.03 | $309.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $102.33 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $389.05 | $467.74 | $467.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $93.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $61.66 | $61.66 |
Where Pennsylvania sits
The same service costs 9.8 times more in Oklahoma 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· 47th of 51
$676
OK $4,365UT $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.