How much rates vary
Facilitymedian $372 · 10th to 90th $100 to $6,310Professionalmedian $141 · 10th to 90th $95 to $240
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 $109.65 Median $537.03 Typical High $6,165.95 | Facility | None | $109.65 | $537.03 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $213.80 | Professional | None | $95.50 | $141.25 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $89.13 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $63.10 | $89.13 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $275.42 | Professional | None | $223.87 | $275.42 | $275.42 |
AmeriHealth Setting Facility Modifier None Typical Low $2,951.21 Median $13,489.63 Typical High $20,417.38 | Facility | None | $2,951.21 | $13,489.63 | $20,417.38 |
AmeriHealth Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $218.78 | Professional | None | $120.23 | $186.21 | $218.78 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $8,709.64 | Facility | None | $1,202.26 | $1,412.54 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $56,234.13 | Professional | None | $177.83 | $177.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $181.97 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $144.54 | $181.97 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $309.03 Typical High $549.54 | Facility | None | $120.23 | $309.03 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $257.04 | Professional | None | $89.13 | $128.82 | $257.04 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | None | $302.00 | $302.00 | $316.23 |
Geisinger Setting Facility Modifier None Typical Low $109.65 Median $134.90 Typical High $239.88 | Facility | None | $109.65 | $134.90 | $239.88 |
Geisinger Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $295.12 | Professional | None | $102.33 | $181.97 | $295.12 |
Highmark BCBS Setting Facility Modifier None Typical Low $316.23 Median $549.54 Typical High $1,380.38 | Facility | None | $316.23 | $549.54 | $1,380.38 |
Independence Blue Cross Setting Facility Modifier None Typical Low $302.00 Median $9,332.54 Typical High $20,417.38 | Facility | None | $302.00 | $9,332.54 | $20,417.38 |
Independence Blue Cross Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $218.78 | Professional | None | $120.23 | $186.21 | $218.78 |
Martin's Point Setting Facility Modifier None Typical Low $131.83 Median $724.44 Typical High $5,888.44 | Facility | None | $131.83 | $724.44 | $5,888.44 |
Martin's Point Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $218.78 | Professional | None | $93.33 | $147.91 | $218.78 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $89.13 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $63.10 | $89.13 | $120.23 |
Oscar Health Setting Professional Modifier None Typical Low $154.88 Median $162.18 Typical High $331.13 | Professional | None | $154.88 | $162.18 | $331.13 |
UPMC Health Plan Setting Facility Modifier None Typical Low $100.00 Median $812.83 Typical High $1,862.09 | Facility | None | $100.00 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $181.97 | Professional | None | $100.00 | $141.25 | $181.97 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $251.19 | Professional | None | $97.72 | $154.88 | $251.19 |
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 $45.71 Median $63.10 Typical High $85.11 | Professional | 52 · Reduced service | $45.71 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $25.12 Typical High $34.67 | Professional | 53 · Discontinued | $18.20 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $95.50 Typical High $128.82 | Professional | 54 · Surgery only | $67.61 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.05 Typical High $25.70 | Professional | 55 · Aftercare only | $13.80 | $19.05 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.59 Typical High $16.98 | Professional | 56 · Pre-op care only | $9.12 | $12.59 | $16.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $63.10 Typical High $85.11 | Professional | 52 · Reduced service | $44.67 | $63.10 | $85.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $25.12 Typical High $34.67 | Professional | 53 · Discontinued | $17.78 | $25.12 | $34.67 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $95.50 Typical High $128.82 | Professional | 54 · Surgery only | $67.61 | $95.50 | $128.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.05 Typical High $25.70 | Professional | 55 · Aftercare only | $13.49 | $19.05 | $25.70 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.59 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.91 | $12.59 | $16.98 |
Where Pennsylvania sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 44th of 51
$155
AK $457KY $126
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.