How much rates vary
Facilitymedian $1,738 · 10th to 90th $479 to $5,248Professionalmedian $525 · 10th to 90th $437 to $1,000
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 $537.03 Median $2,344.23 Typical High $8,317.64 | Facility | None | $537.03 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $575.44 | Professional | None | $436.52 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $323.59 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $309.03 | $323.59 | $363.08 |
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 $501.19 Median $794.33 Typical High $1,000.00 | Professional | None | $501.19 | $794.33 | $1,000.00 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $630.96 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $398.11 | $630.96 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,584.89 Typical High $2,754.23 | Facility | None | $338.84 | $1,584.89 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $954.99 | Professional | None | $467.74 | $537.03 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $776.25 | Professional | None | $724.44 | $724.44 | $776.25 |
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 $467.74 Median $616.60 Typical High $1,000.00 | Professional | None | $467.74 | $616.60 | $1,000.00 |
Highmark BCBS Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $19,952.62 | Facility | None | $912.01 | $912.01 | $19,952.62 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $7,244.36 | Facility | None | $588.84 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $562.34 | Professional | None | $436.52 | $457.09 | $562.34 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $323.59 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $309.03 | $323.59 | $338.84 |
Oscar Health Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,122.02 | Professional | None | $575.44 | $676.08 | $1,122.02 |
UPMC Health Plan Setting Facility Modifier None Typical Low $489.78 Median $1,513.56 Typical High $2,511.89 | Facility | None | $489.78 | $1,513.56 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $489.78 Median $2,511.89 Typical High $2,511.89 | Professional | None | $489.78 | $2,511.89 | $2,511.89 |
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 $467.74 Median $588.84 Typical High $1,000.00 | Professional | None | $467.74 | $588.84 | $1,000.00 |
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 $218.78 Median $229.09 Typical High $257.04 | Professional | 52 · Reduced service | $218.78 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $87.10 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $77.62 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $51.29 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,202.26 Typical High $1,513.56 | Professional | 50 · Both sides | $758.58 | $1,202.26 | $1,513.56 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $229.09 Typical High $239.88 | Professional | 52 · Reduced service | $218.78 | $229.09 | $239.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $97.72 | Professional | 53 · Discontinued | $87.10 | $91.20 | $97.72 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $331.13 | $346.74 | $363.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $72.44 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $72.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $48.98 |
Where Pennsylvania sits
The same service costs 5.5 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· 43rd of 51
$617
AK $2,042UT $372
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.