How much rates vary
Facilitymedian $2,399 · 10th to 90th $776 to $6,310Professionalmedian $977 · 10th to 90th $851 to $1,660
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 $3,890.45 Typical High $8,511.38 | Facility | None | $851.14 | $3,890.45 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,096.48 | Professional | None | $851.14 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $691.83 |
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 $1,513.56 Median $1,513.56 Typical High $56,234.13 | Professional | None | $1,513.56 | $1,513.56 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,230.27 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $776.25 | $1,230.27 | $1,584.89 |
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 $912.01 Median $1,047.13 Typical High $1,862.09 | Professional | None | $912.01 | $1,047.13 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,479.11 | Professional | None | $1,380.38 | $1,380.38 | $1,479.11 |
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 $891.25 Median $1,202.26 Typical High $1,905.46 | Professional | None | $891.25 | $1,202.26 | $1,905.46 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $12,589.25 Typical High $32,359.37 | Facility | None | $3,235.94 | $12,589.25 | $32,359.37 |
Martin's Point Setting Facility Modifier None Typical Low $851.14 Median $3,801.89 Typical High $8,317.64 | Facility | None | $851.14 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,071.52 | Professional | None | $851.14 | $891.25 | $1,071.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $660.69 |
Oscar Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,348.96 | $2,137.96 |
UPMC Health Plan Setting Facility Modifier None Typical Low $933.25 Median $3,388.44 Typical High $6,606.93 | Facility | None | $933.25 | $3,388.44 | $6,606.93 |
UPMC Health Plan Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,096.48 | Professional | None | $933.25 | $1,096.48 | $1,096.48 |
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 $912.01 Median $1,122.02 Typical High $1,949.84 | Professional | None | $912.01 | $1,122.02 | $1,949.84 |
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 $426.58 Median $446.68 Typical High $501.19 | Professional | 52 · Reduced service | $426.58 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $169.82 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $100.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $446.68 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $446.68 | $467.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $186.21 | Professional | 53 · Discontinued | $169.82 | $177.83 | $186.21 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $630.96 | $660.69 | $707.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $141.25 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $93.33 |
Where Pennsylvania sits
The same service costs 5.9 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· 46th of 51
$1,096
OK $4,074UT $692
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.