How much rates vary
Facilitymedian $2,754 · 10th to 90th $724 to $6,918Professionalmedian $1,023 · 10th to 90th $891 to $1,738
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 $891.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $891.25 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,096.48 | Professional | None | $891.25 | $933.25 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $645.65 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $616.60 | $645.65 | $724.44 |
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 $1,584.89 Median $1,584.89 Typical High $56,234.13 | Professional | None | $1,584.89 | $1,584.89 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,288.25 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $812.83 | $1,288.25 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,511.89 Typical High $4,365.16 | Facility | None | $524.81 | $2,511.89 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,949.84 | Professional | None | $954.99 | $1,071.52 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,445.44 | $1,445.44 | $1,513.56 |
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 $933.25 Median $1,258.93 Typical High $1,995.26 | Professional | None | $933.25 | $1,258.93 | $1,995.26 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Martin's Point Setting Facility Modifier None Typical Low $891.25 Median $3,715.35 Typical High $8,317.64 | Facility | None | $891.25 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,071.52 | Professional | None | $891.25 | $933.25 | $1,071.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $645.65 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $645.65 | $691.83 |
Oscar Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,412.54 | $2,238.72 |
UPMC Health Plan Setting Facility Modifier None Typical Low $977.24 Median $4,786.30 Typical High $9,549.93 | Facility | None | $977.24 | $4,786.30 | $9,549.93 |
UPMC Health Plan Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | None | $977.24 | $1,174.90 | $1,174.90 |
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 $954.99 Median $1,174.90 Typical High $2,041.74 | Professional | None | $954.99 | $1,174.90 | $2,041.74 |
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 $436.52 Median $467.74 Typical High $512.86 | Professional | 52 · Reduced service | $436.52 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $691.83 Typical High $776.25 | Professional | 54 · Surgery only | $660.69 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $154.88 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $104.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $467.74 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $467.74 | $489.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $186.21 | $194.98 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $691.83 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $691.83 | $741.31 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $147.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $97.72 |
Where Pennsylvania sits
The same service costs 5.6 times more in Alaska 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· 45th of 51
$1,148
AK $4,074UT $724
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.