How much rates vary
Facilitymedian $2,138 · 10th to 90th $708 to $6,607Professionalmedian $832 · 10th to 90th $708 to $1,413
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 $724.44 Median $3,801.89 Typical High $8,317.64 | Facility | None | $724.44 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $933.25 | Professional | None | $707.95 | $741.31 | $933.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $588.84 |
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 $1,288.25 Median $1,288.25 Typical High $56,234.13 | Professional | None | $1,288.25 | $1,288.25 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $2,754.23 | Facility | None | $524.81 | $1,659.59 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,548.82 | Professional | None | $776.25 | $912.01 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,258.93 | Professional | None | $1,174.90 | $1,174.90 | $1,258.93 |
Geisinger Setting Facility Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $3,630.78 | Facility | None | $1,659.59 | $2,089.30 | $3,630.78 |
Geisinger Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,621.81 | Professional | None | $758.58 | $1,023.29 | $1,621.81 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.50 Median $0.50 Typical High $0.50 | Facility | None | $0.50 | $0.50 | $0.50 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,715.35 Typical High $8,317.64 | Facility | None | $776.25 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $933.25 | Professional | None | $707.95 | $741.31 | $933.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $562.34 |
Oscar Health Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,862.09 | Professional | None | $933.25 | $1,148.15 | $1,862.09 |
UPMC Health Plan Setting Facility Modifier None Typical Low $794.33 Median $4,786.30 Typical High $9,549.93 | Facility | None | $794.33 | $4,786.30 | $9,549.93 |
UPMC Health Plan Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | None | $794.33 | $1,000.00 | $1,000.00 |
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 $776.25 Median $954.99 Typical High $1,659.59 | Professional | None | $776.25 | $954.99 | $1,659.59 |
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 $371.54 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $630.96 | Professional | 54 · Surgery only | $537.03 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $125.89 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $74.13 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $74.13 | $85.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $371.54 Typical High $398.11 | Professional | 52 · Reduced service | $354.81 | $371.54 | $398.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $158.49 | Professional | 53 · Discontinued | $144.54 | $151.36 | $158.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $537.03 | $562.34 | $602.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $120.23 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $120.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $74.13 Typical High $79.43 | Professional | 56 · Pre-op care only | $70.79 | $74.13 | $79.43 |
Where Pennsylvania sits
The same service costs 6.6 times more in Oklahoma 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· 44th of 51
$933
OK $3,802UT $575
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.