How much rates vary
Facilitymedian $5,495 · 10th to 90th $676 to $27,542Professionalmedian $851 · 10th to 90th $708 to $1,514
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 $851.14 Median $3,090.30 Typical High $8,511.38 | Facility | None | $851.14 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $851.14 | Professional | None | $707.95 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $588.84 | $588.84 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,187.76 Typical High $28,183.83 | Facility | None | $478.63 | $2,187.76 | $28,183.83 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,513.56 | Professional | None | $741.31 | $831.76 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,122.02 | $1,122.02 | $1,202.26 |
Geisinger Setting Facility Modifier None Typical Low $16,982.44 Median $21,379.62 Typical High $37,153.52 | Facility | None | $16,982.44 | $21,379.62 | $37,153.52 |
Geisinger Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,548.82 | Professional | None | $724.44 | $977.24 | $1,548.82 |
Martin's Point Setting Facility Modifier None Typical Low $851.14 Median $2,754.23 Typical High $8,317.64 | Facility | None | $851.14 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $851.14 | Professional | None | $707.95 | $851.14 | $851.14 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $588.84 | $588.84 |
Oscar Health Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,737.80 | Professional | None | $870.96 | $912.01 | $1,737.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $776.25 Median $851.14 Typical High $851.14 | Facility | None | $776.25 | $851.14 | $851.14 |
UPMC Health Plan Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | None | $776.25 | $851.14 | $851.14 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $14,454.40 | Facility | None | $2,818.38 | $5,495.41 | $14,454.40 |
United Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,584.89 | Professional | None | $741.31 | $933.25 | $1,584.89 |
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 $354.81 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $426.58 | $426.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $169.82 | $169.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $630.96 | $630.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $85.11 | $85.11 |
Where Pennsylvania sits
The same service costs 6.8 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· 45th of 51
$871
AK $3,715TX $550
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.