How much rates vary
Facilitymedian $2,570 · 10th to 90th $692 to $6,310Professionalmedian $933 · 10th to 90th $776 to $1,479
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 $933.25 Median $3,090.30 Typical High $8,511.38 | Facility | None | $933.25 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $933.25 | Professional | None | $776.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $645.65 | $645.65 |
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 $1,380.38 Median $1,380.38 Typical High $56,234.13 | Professional | None | $1,380.38 | $1,380.38 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,148.15 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $724.44 | $1,148.15 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,187.76 Typical High $4,365.16 | Facility | None | $478.63 | $2,187.76 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,659.59 | Professional | None | $812.83 | $912.01 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,318.26 | Professional | None | $1,230.27 | $1,230.27 | $1,318.26 |
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 $812.83 Median $1,071.52 Typical High $1,698.24 | Professional | None | $812.83 | $1,071.52 | $1,698.24 |
Martin's Point Setting Facility Modifier None Typical Low $933.25 Median $2,754.23 Typical High $8,317.64 | Facility | None | $933.25 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $933.25 | Professional | None | $776.25 | $933.25 | $933.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $645.65 | $645.65 |
Oscar Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,122.02 | $1,949.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $851.14 Median $1,513.56 Typical High $2,951.21 | Facility | None | $851.14 | $1,513.56 | $2,951.21 |
UPMC Health Plan Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,071.52 | Professional | None | $851.14 | $1,071.52 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,737.80 | Professional | None | $812.83 | $1,023.29 | $1,737.80 |
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 $389.05 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $93.33 | $93.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $467.74 | $467.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $186.21 | $186.21 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $691.83 | $691.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $138.04 | $138.04 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $93.33 | $93.33 |
Where Pennsylvania sits
The same service costs 5.6 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
$1,000
AK $3,548UT $631
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.