How much rates vary
Facilitymedian $2,951 · 10th to 90th $776 to $6,918Professionalmedian $1,445 · 10th to 90th $1,230 to $2,455
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 $1,230.27 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,288.25 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $1,023.29 |
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 $2,238.72 Median $2,238.72 Typical High $56,234.13 | Professional | None | $2,238.72 | $2,238.72 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,778.28 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,778.28 | $2,238.72 |
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 $1,318.26 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,513.56 | $2,691.53 |
Emblem Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,137.96 | Professional | None | $1,995.26 | $1,995.26 | $2,137.96 |
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 $1,288.25 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,737.80 | $2,754.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $21,877.62 Median $21,877.62 Typical High $21,877.62 | Facility | None | $21,877.62 | $21,877.62 | $21,877.62 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $3,715.35 Typical High $8,317.64 | Facility | None | $954.99 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,288.25 | $1,513.56 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $954.99 |
Oscar Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,584.89 | $1,949.84 | $3,162.28 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $9,549.93 | Facility | None | $1,380.38 | $4,786.30 | $9,549.93 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,380.38 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,659.59 | $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 $616.60 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $295.12 | Professional | 53 · Discontinued | $245.47 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,096.48 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $147.91 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $147.91 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $645.65 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $645.65 | $691.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $257.04 | $275.42 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,023.29 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,023.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $204.17 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $204.17 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $138.04 |
Where Pennsylvania sits
The same service costs 5.8 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· 46th of 51
$1,549
AK $5,623UT $977
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.