How much rates vary
Facilitymedian $1,318 · 10th to 90th $457 to $4,898Professionalmedian $437 · 10th to 90th $372 to $813
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 $2,454.71 Typical High $8,317.64 | Facility | None | $537.03 | $2,454.71 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $467.74 | Professional | None | $371.54 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $269.15 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $257.04 | $269.15 | $302.00 |
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 $426.58 Median $676.08 Typical High $831.76 | Professional | None | $426.58 | $676.08 | $831.76 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $537.03 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $338.84 | $537.03 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $933.25 Typical High $1,659.59 | Facility | None | $346.74 | $933.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $812.83 | Professional | None | $407.38 | $446.68 | $812.83 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $660.69 | Professional | None | $616.60 | $616.60 | $660.69 |
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 $398.11 Median $512.86 Typical High $831.76 | Professional | None | $398.11 | $512.86 | $831.76 |
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 $371.54 Median $389.05 Typical High $457.09 | Professional | None | $371.54 | $389.05 | $457.09 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $269.15 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $257.04 | $269.15 | $288.40 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $933.25 | Professional | None | $489.78 | $512.86 | $933.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $407.38 Median $1,122.02 Typical High $2,187.76 | Facility | None | $407.38 | $1,122.02 | $2,187.76 |
UPMC Health Plan Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $457.09 | Professional | None | $407.38 | $457.09 | $457.09 |
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 $398.11 Median $489.78 Typical High $851.14 | Professional | None | $398.11 | $489.78 | $851.14 |
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 $186.21 Median $194.98 Typical High $218.78 | Professional | 52 · Reduced service | $186.21 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $77.62 Typical High $87.10 | Professional | 53 · Discontinued | $74.13 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $288.40 Typical High $323.59 | Professional | 54 · Surgery only | $275.42 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $56.23 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $43.65 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $1,000.00 Typical High $1,258.93 | Professional | 50 · Both sides | $630.96 | $1,000.00 | $1,258.93 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $194.98 Typical High $204.17 | Professional | 52 · Reduced service | $186.21 | $194.98 | $204.17 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $77.62 Typical High $81.28 | Professional | 53 · Discontinued | $74.13 | $77.62 | $81.28 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $288.40 Typical High $309.03 | Professional | 54 · Surgery only | $275.42 | $288.40 | $309.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $57.54 Typical High $61.66 | Professional | 55 · Aftercare only | $56.23 | $57.54 | $61.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $40.74 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $40.74 |
Where Pennsylvania sits
The same service costs 5.1 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· 45th of 51
$490
AK $1,698UT $331
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.