How much rates vary
Facilitymedian $2,344 · 10th to 90th $661 to $6,026Professionalmedian $871 · 10th to 90th $759 to $1,413
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 $758.58 Median $2,454.71 Typical High $8,317.64 | Facility | None | $758.58 | $2,454.71 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $954.99 | Professional | None | $758.58 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $630.96 |
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 $870.96 Median $870.96 Typical High $912.01 | Professional | None | $870.96 | $870.96 | $912.01 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,122.02 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $691.83 | $1,122.02 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,511.89 Typical High $4,365.16 | Facility | None | $501.19 | $2,511.89 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,659.59 | Professional | None | $812.83 | $933.25 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,318.26 | Professional | None | $1,230.27 | $1,230.27 | $1,318.26 |
Geisinger Setting Facility Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $5,754.40 | Facility | None | $2,630.27 | $3,311.31 | $5,754.40 |
Geisinger Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,698.24 | Professional | None | $812.83 | $1,071.52 | $1,698.24 |
Martin's Point Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $7,244.36 | Facility | None | $758.58 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $954.99 | Professional | None | $758.58 | $794.33 | $954.99 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $588.84 |
Oscar Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,071.52 | $1,905.46 |
UPMC Health Plan Setting Facility Modifier None Typical Low $851.14 Median $891.25 Typical High $891.25 | Facility | None | $851.14 | $891.25 | $891.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | None | $851.14 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $6,025.60 | Facility | None | $812.83 | $1,318.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,778.28 | Professional | None | $812.83 | $1,023.29 | $1,778.28 |
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 $380.19 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $380.19 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $151.36 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $575.44 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $89.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $380.19 | $398.11 | $426.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $158.49 | $169.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $602.56 | $630.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $85.11 |
Where Pennsylvania sits
The same service costs 5.8 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· 46th of 51
$912
AK $3,548UT $617
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.