How much rates vary
Facilitymedian $1,862 · 10th to 90th $676 to $6,457Professionalmedian $1,259 · 10th to 90th $372 to $2,951
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 $645.65 Median $3,090.30 Typical High $8,511.38 | Facility | None | $645.65 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $954.99 Typical High $1,584.89 | Professional | None | $338.84 | $954.99 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $524.81 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $234.42 | $524.81 | $1,096.48 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $56,234.13 | Professional | None | $602.56 | $602.56 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,819.70 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,819.70 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $2,290.87 | Facility | None | $501.19 | $1,174.90 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $1,096.48 Typical High $3,019.95 | Professional | None | $371.54 | $1,096.48 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,398.83 | Professional | None | $2,344.23 | $2,344.23 | $2,398.83 |
Geisinger Setting Facility Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,511.89 | Facility | None | $1,148.15 | $1,445.44 | $2,511.89 |
Geisinger Setting Professional Modifier None Typical Low $630.96 Median $1,905.46 Typical High $4,168.69 | Professional | None | $630.96 | $1,905.46 | $4,168.69 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $5,495.41 Typical High $8,912.51 | Facility | None | $1,737.80 | $5,495.41 | $8,912.51 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $8,317.64 | Facility | None | $724.44 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $338.84 Median $954.99 Typical High $1,584.89 | Professional | None | $338.84 | $954.99 | $1,584.89 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $467.74 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $234.42 | $467.74 | $1,096.48 |
Oscar Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,951.21 Typical High $5,623.41 | Professional | None | $1,659.59 | $2,951.21 | $5,623.41 |
UPMC Health Plan Setting Facility Modifier None Typical Low $758.58 Median $3,981.07 Typical High $7,585.78 | Facility | None | $758.58 | $3,981.07 | $7,585.78 |
UPMC Health Plan Setting Professional Modifier None Typical Low $371.54 Median $1,318.26 Typical High $3,981.07 | Professional | None | $371.54 | $1,318.26 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,309.57 | Facility | None | $1,380.38 | $2,398.83 | $6,309.57 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,202.26 Typical High $2,884.03 | Professional | None | $380.19 | $1,202.26 | $2,884.03 |
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 $165.96 Median $380.19 Typical High $794.33 | Professional | 52 · Reduced service | $165.96 | $380.19 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $151.36 Typical High $316.23 | Professional | 53 · Discontinued | $67.61 | $151.36 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $562.34 Typical High $1,174.90 | Professional | 54 · Surgery only | $251.19 | $562.34 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $114.82 Typical High $239.88 | Professional | 55 · Aftercare only | $50.12 | $114.82 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $75.86 Typical High $158.49 | Professional | 56 · Pre-op care only | $33.88 | $75.86 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $338.84 Typical High $794.33 | Professional | 52 · Reduced service | $165.96 | $338.84 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $134.90 Typical High $316.23 | Professional | 53 · Discontinued | $67.61 | $134.90 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $501.19 Typical High $1,174.90 | Professional | 54 · Surgery only | $251.19 | $501.19 | $1,174.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $100.00 Typical High $239.88 | Professional | 55 · Aftercare only | $50.12 | $100.00 | $239.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $67.61 Typical High $158.49 | Professional | 56 · Pre-op care only | $33.88 | $67.61 | $158.49 |
Where Pennsylvania sits
The same service costs 4.9 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· 43rd of 51
$1,288
AK $3,020TX $617
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.