How much rates vary
Facilitymedian $2,692 · 10th to 90th $724 to $6,607Professionalmedian $891 · 10th to 90th $741 to $1,445
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 $3,890.45 Typical High $8,317.64 | Facility | None | $831.76 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $912.01 | Professional | None | $741.31 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $630.96 | $630.96 |
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 $1,318.26 Median $1,318.26 Typical High $56,234.13 | Professional | None | $1,318.26 | $1,318.26 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,096.48 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $691.83 | $1,096.48 | $1,412.54 |
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 $794.33 Median $891.25 Typical High $1,621.81 | Professional | None | $794.33 | $891.25 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,202.26 | $1,202.26 | $1,288.25 |
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 $776.25 Median $1,023.29 Typical High $1,659.59 | Professional | None | $776.25 | $1,023.29 | $1,659.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $16,218.10 Median $16,218.10 Typical High $16,218.10 | Facility | None | $16,218.10 | $16,218.10 | $16,218.10 |
Martin's Point Setting Facility Modifier None Typical Low $891.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $891.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $912.01 | Professional | None | $741.31 | $891.25 | $912.01 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $630.96 | $630.96 |
Oscar Health Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,737.80 | Professional | None | $954.99 | $1,122.02 | $1,737.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $812.83 Median $1,737.80 Typical High $3,388.44 | Facility | None | $812.83 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,071.52 | Professional | None | $812.83 | $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 $794.33 Median $977.24 Typical High $1,698.24 | Professional | None | $794.33 | $977.24 | $1,698.24 |
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 $371.54 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $446.68 | $446.68 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $177.83 | $177.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $676.08 | $676.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $89.13 | $89.13 |
Where Pennsylvania sits
The same service costs 5.9 times more in Alaska than in Texas. 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
$955
AK $3,467TX $589
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.