How much rates vary
Facilitymedian $1,288 · 10th to 90th $389 to $5,754Professionalmedian $309 · 10th to 90th $209 to $603
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 $263.03 Median $1,479.11 Typical High $7,585.78 | Facility | None | $263.03 | $1,479.11 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $501.19 | Professional | None | $199.53 | $302.00 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $213.80 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $141.25 | $213.80 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $660.69 | Professional | None | $251.19 | $363.08 | $660.69 |
AmeriHealth Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $5,248.07 | Facility | None | $575.44 | $794.33 | $5,248.07 |
AmeriHealth Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $512.86 | Professional | None | $295.12 | $467.74 | $512.86 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,981.07 | $6,025.60 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $741.31 Median $1,288.25 Typical High $1,288.25 | Professional | None | $741.31 | $1,288.25 | $1,288.25 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $467.74 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $275.42 | $467.74 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $977.24 Typical High $1,862.09 | Facility | None | $478.63 | $977.24 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $602.56 | Professional | None | $223.87 | $354.81 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $61.66 Median $371.54 Typical High $436.52 | Professional | None | $61.66 | $371.54 | $436.52 |
Geisinger Setting Facility Modifier None Typical Low $977.24 Median $1,202.26 Typical High $2,137.96 | Facility | None | $977.24 | $1,202.26 | $2,137.96 |
Geisinger Setting Professional Modifier None Typical Low $234.42 Median $467.74 Typical High $741.31 | Professional | None | $234.42 | $467.74 | $741.31 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $4,365.16 Typical High $7,585.78 | Facility | None | $1,479.11 | $4,365.16 | $7,585.78 |
Independence Blue Cross Setting Facility Modifier None Typical Low $537.03 Median $776.25 Typical High $9,332.54 | Facility | None | $537.03 | $776.25 | $9,332.54 |
Independence Blue Cross Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $467.74 | Professional | None | $295.12 | $316.23 | $467.74 |
Martin's Point Setting Facility Modifier None Typical Low $269.15 Median $1,584.89 Typical High $7,244.36 | Facility | None | $269.15 | $1,584.89 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $501.19 | Professional | None | $199.53 | $302.00 | $501.19 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $213.80 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $141.25 | $213.80 | $213.80 |
Oscar Health Setting Facility Modifier None Typical Low $1,202.26 Median $4,786.30 Typical High $6,606.93 | Facility | None | $1,202.26 | $4,786.30 | $6,606.93 |
Oscar Health Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $1,000.00 | Professional | None | $398.11 | $489.78 | $1,000.00 |
UPMC Health Plan Setting Facility Modifier None Typical Low $323.59 Median $1,258.93 Typical High $2,884.03 | Facility | None | $323.59 | $1,258.93 | $2,884.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $223.87 Median $389.05 Typical High $602.56 | Professional | None | $223.87 | $389.05 | $602.56 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $3,981.07 | Facility | None | $812.83 | $1,318.26 | $3,981.07 |
United Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $630.96 | Professional | None | $229.09 | $354.81 | $630.96 |
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 $100.00 Median $151.36 Typical High $154.88 | Professional | 52 · Reduced service | $100.00 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $60.26 Typical High $61.66 | Professional | 53 · Discontinued | $40.74 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $151.36 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $45.71 Typical High $46.77 | Professional | 55 · Aftercare only | $30.20 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $30.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.95 | $30.20 | $30.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $151.36 Typical High $154.88 | Professional | 52 · Reduced service | $100.00 | $151.36 | $154.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $60.26 Typical High $61.66 | Professional | 53 · Discontinued | $40.74 | $60.26 | $61.66 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $151.36 | $229.09 | $229.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $45.71 Typical High $46.77 | Professional | 55 · Aftercare only | $30.20 | $45.71 | $46.77 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $30.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.95 | $30.20 | $30.90 |
Where Pennsylvania sits
The same service costs 4.6 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· 38th of 51
$389
AK $1,259UT $275
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.