How much rates vary
Facilitymedian $912 · 10th to 90th $107 to $5,129Professionalmedian $191 · 10th to 90th $155 to $324
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 $204.17 Median $2,137.96 Typical High $7,943.28 | Facility | None | $204.17 | $2,137.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $204.17 | Professional | None | $147.91 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $125.89 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $102.33 | $125.89 | $144.54 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,981.07 | $6,025.60 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $446.68 | Professional | None | $269.15 | $302.00 | $446.68 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $239.88 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $151.36 | $239.88 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $380.19 Typical High $851.14 | Facility | None | $95.50 | $380.19 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $331.13 | Professional | None | $158.49 | $190.55 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | None | $309.03 | $309.03 | $323.59 |
Geisinger Setting Facility Modifier None Typical Low $87.10 Median $107.15 Typical High $190.55 | Facility | None | $87.10 | $107.15 | $190.55 |
Geisinger Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $371.54 | Professional | None | $165.96 | $234.42 | $371.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Facility | None | $11,748.98 | $11,748.98 | $11,748.98 |
Martin's Point Setting Facility Modifier None Typical Low $204.17 Median $1,995.26 Typical High $7,244.36 | Facility | None | $204.17 | $1,995.26 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $204.17 | Professional | None | $147.91 | $177.83 | $204.17 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $125.89 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $102.33 | $125.89 | $144.54 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $380.19 | Professional | None | $218.78 | $338.84 | $380.19 |
UPMC Health Plan Setting Facility Modifier None Typical Low $186.21 Median $2,238.72 Typical High $5,248.07 | Facility | None | $186.21 | $2,238.72 | $5,248.07 |
UPMC Health Plan Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $316.23 | Professional | None | $162.18 | $204.17 | $316.23 |
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 $158.49 Median $199.53 Typical High $346.74 | Professional | None | $158.49 | $199.53 | $346.74 |
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 $74.13 Median $89.13 Typical High $102.33 | Professional | 52 · Reduced service | $74.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $35.48 Typical High $40.74 | Professional | 53 · Discontinued | $29.51 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $109.65 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $21.88 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $17.78 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.79 | $17.78 | $20.42 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $89.13 Typical High $102.33 | Professional | 52 · Reduced service | $74.13 | $89.13 | $102.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $35.48 Typical High $40.74 | Professional | 53 · Discontinued | $29.51 | $35.48 | $40.74 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $109.65 | $134.90 | $154.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $21.88 | $26.92 | $30.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $17.78 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.79 | $17.78 | $20.42 |
Where Pennsylvania sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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· 44th of 51
$200
OK $891FL $182
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.