How much rates vary
Facilitymedian $2,188 · 10th to 90th $813 to $7,079Professionalmedian $575 · 10th to 90th $501 to $1,047
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 $831.76 Median $5,495.41 Typical High $8,709.64 | Facility | None | $831.76 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $630.96 | Professional | None | $501.19 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $363.08 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $354.81 | $363.08 | $389.05 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $8,709.64 | Facility | None | $3,981.07 | $7,413.10 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $1,071.52 | Professional | None | $562.34 | $891.25 | $1,071.52 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $707.95 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $446.68 | $707.95 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $3,235.94 | Facility | None | $707.95 | $1,737.80 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $1,071.52 | Professional | None | $467.74 | $575.44 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | None | $851.14 | $851.14 | $954.99 |
Geisinger Setting Facility Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,715.35 | Facility | None | $1,698.24 | $2,137.96 | $3,715.35 |
Geisinger Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,096.48 | Professional | None | $478.63 | $691.83 | $1,096.48 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $4,897.79 Typical High $8,709.64 | Facility | None | $912.01 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $588.84 | Professional | None | $501.19 | $512.86 | $588.84 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $363.08 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $354.81 | $363.08 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,023.29 | Professional | None | $562.34 | $630.96 | $1,023.29 |
UPMC Health Plan Setting Facility Modifier None Typical Low $512.86 Median $2,570.40 Typical High $5,011.87 | Facility | None | $512.86 | $2,570.40 | $5,011.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | None | $512.86 | $512.86 | $549.54 |
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 $489.78 Median $645.65 Typical High $1,122.02 | Professional | None | $489.78 | $645.65 | $1,122.02 |
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 $251.19 Median $257.04 Typical High $275.42 | Professional | 52 · Reduced service | $251.19 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $109.65 | Professional | 53 · Discontinued | $100.00 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $389.05 Typical High $416.87 | Professional | 54 · Surgery only | $380.19 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $51.29 Typical High $54.95 | Professional | 56 · Pre-op care only | $50.12 | $51.29 | $54.95 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,348.96 Typical High $1,621.81 | Professional | 50 · Both sides | $831.76 | $1,348.96 | $1,621.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $257.04 Typical High $263.03 | Professional | 52 · Reduced service | $251.19 | $257.04 | $263.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $104.71 | Professional | 53 · Discontinued | $100.00 | $102.33 | $104.71 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $389.05 Typical High $398.11 | Professional | 54 · Surgery only | $380.19 | $389.05 | $398.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $79.43 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $79.43 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $51.29 Typical High $52.48 | Professional | 56 · Pre-op care only | $50.12 | $51.29 | $52.48 |
Where Pennsylvania sits
The same service costs 8.7 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· 41st of 51
$676
OK $3,631UT $417
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.