How much rates vary
Facilitymedian $1,778 · 10th to 90th $603 to $5,495Professionalmedian $427 · 10th to 90th $363 to $776
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 $588.84 Median $3,801.89 Typical High $8,317.64 | Facility | None | $588.84 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $489.78 | Professional | None | $363.08 | $371.54 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $263.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $251.19 | $263.03 | $295.12 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $794.33 | Professional | None | $407.38 | $645.65 | $794.33 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $331.13 | $524.81 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $2,754.23 | Facility | None | $501.19 | $1,659.59 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $776.25 | Professional | None | $389.05 | $426.58 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $645.65 | Professional | None | $602.56 | $602.56 | $645.65 |
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 $380.19 Median $501.19 Typical High $812.83 | Professional | None | $380.19 | $501.19 | $812.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $16,982.44 | Facility | None | $13,489.63 | $13,489.63 | $16,982.44 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $3,715.35 Typical High $8,317.64 | Facility | None | $588.84 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $489.78 | Professional | None | $363.08 | $371.54 | $489.78 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $263.03 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $251.19 | $263.03 | $275.42 |
Oscar Health Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $891.25 | Professional | None | $467.74 | $512.86 | $891.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $398.11 Median $1,737.80 Typical High $3,467.37 | Facility | None | $398.11 | $1,737.80 | $3,467.37 |
UPMC Health Plan Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | None | $398.11 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,897.79 | Facility | None | $812.83 | $1,318.26 | $4,897.79 |
United Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $812.83 | Professional | None | $380.19 | $478.63 | $812.83 |
11 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 $181.97 Median $186.21 Typical High $208.93 | Professional | 52 · Reduced service | $181.97 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $83.18 | Professional | 53 · Discontinued | $72.44 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $269.15 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $37.15 Typical High $41.69 | Professional | 56 · Pre-op care only | $36.31 | $37.15 | $41.69 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $977.24 Typical High $1,202.26 | Professional | 50 · Both sides | $616.60 | $977.24 | $1,202.26 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $186.21 Typical High $199.53 | Professional | 52 · Reduced service | $181.97 | $186.21 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $72.44 | $74.13 | $79.43 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $269.15 | $281.84 | $295.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $58.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $36.31 | $37.15 | $39.81 |
Where Pennsylvania sits
The same service costs 6.0 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
$501
OK $1,862UT $309
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.