How much rates vary
Facilitymedian $1,738 · 10th to 90th $447 to $5,129Professionalmedian $363 · 10th to 90th $309 to $676
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 $309.03 Median $316.23 Typical High $380.19 | Professional | None | $309.03 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $223.87 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $213.80 | $223.87 | $245.47 |
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 $346.74 Median $549.54 Typical High $707.95 | Professional | None | $346.74 | $549.54 | $707.95 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $446.68 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $281.84 | $446.68 | $562.34 |
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 $338.84 Median $371.54 Typical High $660.69 | Professional | None | $338.84 | $371.54 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | None | $512.86 | $512.86 | $549.54 |
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 $323.59 Median $426.58 Typical High $691.83 | Professional | None | $323.59 | $426.58 | $691.83 |
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 $309.03 Median $316.23 Typical High $371.54 | Professional | None | $309.03 | $316.23 | $371.54 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $223.87 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $213.80 | $223.87 | $234.42 |
Oscar Health Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $741.31 | Professional | None | $398.11 | $446.68 | $741.31 |
UPMC Health Plan Setting Facility Modifier None Typical Low $338.84 Median $1,122.02 Typical High $2,238.72 | Facility | None | $338.84 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | None | $338.84 | $407.38 | $407.38 |
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 $323.59 Median $407.38 Typical High $691.83 | Professional | None | $323.59 | $407.38 | $691.83 |
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 $151.36 Median $158.49 Typical High $173.78 | Professional | 52 · Reduced service | $151.36 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $70.79 | Professional | 53 · Discontinued | $61.66 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $229.09 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $52.48 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $34.67 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $831.76 Typical High $1,047.13 | Professional | 50 · Both sides | $524.81 | $831.76 | $1,047.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $158.49 Typical High $169.82 | Professional | 52 · Reduced service | $151.36 | $158.49 | $169.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $67.61 | Professional | 53 · Discontinued | $61.66 | $63.10 | $67.61 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $239.88 Typical High $251.19 | Professional | 54 · Surgery only | $229.09 | $239.88 | $251.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $50.12 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $50.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $33.88 |
Where Pennsylvania sits
The same service costs 6.9 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
$427
AK $1,905UT $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.