How much rates vary
Facilitymedian $2,570 · 10th to 90th $661 to $6,166Professionalmedian $676 · 10th to 90th $562 to $1,096
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 $676.08 Median $3,890.45 Typical High $8,317.64 | Facility | None | $676.08 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | None | $562.34 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $389.05 | $478.63 | $478.63 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | None | $851.14 | $1,000.00 | $1,000.00 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $831.76 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $524.81 | $831.76 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,511.89 Typical High $4,365.16 | Facility | None | $501.19 | $2,511.89 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $1,202.26 | Professional | None | $602.56 | $660.69 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $977.24 | Professional | None | $912.01 | $912.01 | $977.24 |
Geisinger Setting Facility Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $5,754.40 | Facility | None | $2,630.27 | $3,311.31 | $5,754.40 |
Geisinger Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,230.27 | Professional | None | $588.84 | $776.25 | $1,230.27 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | None | $562.34 | $676.08 | $676.08 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $389.05 | $478.63 | $478.63 |
Oscar Health Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,412.54 | Professional | None | $724.44 | $776.25 | $1,412.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $616.60 Median $1,737.80 Typical High $3,388.44 | Facility | None | $616.60 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | None | $616.60 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $6,025.60 | Facility | None | $812.83 | $1,318.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,258.93 | Professional | None | $588.84 | $741.31 | $1,258.93 |
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 $281.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $416.87 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $416.87 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $67.61 |
Where Pennsylvania sits
The same service costs 5.4 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· 47th of 51
$724
AK $2,570UT $479
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.