How much rates vary
Facilitymedian $1,778 · 10th to 90th $589 to $5,248Professionalmedian $437 · 10th to 90th $380 to $794
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 $645.65 Median $3,090.30 Typical High $8,511.38 | Facility | None | $645.65 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $446.68 | Professional | None | $371.54 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $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 $467.74 Median $691.83 Typical High $691.83 | Professional | None | $467.74 | $691.83 | $691.83 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $524.81 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $338.84 | $524.81 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,621.81 Typical High $2,818.38 | Facility | None | $478.63 | $1,621.81 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $870.96 | Professional | None | $407.38 | $457.09 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $707.95 | Professional | None | $645.65 | $645.65 | $707.95 |
Geisinger Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $3,715.35 | Facility | None | $1,698.24 | $2,089.30 | $3,715.35 |
Geisinger Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $891.25 | Professional | None | $398.11 | $549.54 | $891.25 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $8,317.64 | Facility | None | $724.44 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $446.68 | Professional | None | $371.54 | $407.38 | $446.68 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $870.96 | Professional | None | $446.68 | $501.19 | $870.96 |
UPMC Health Plan Setting Facility Modifier None Typical Low $380.19 Median $1,513.56 Typical High $3,019.95 | Facility | None | $380.19 | $1,513.56 | $3,019.95 |
UPMC Health Plan Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | None | $380.19 | $380.19 | $446.68 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,466.84 | Facility | None | $812.83 | $1,318.26 | $4,466.84 |
United Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $891.25 | Professional | None | $407.38 | $524.81 | $891.25 |
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 $186.21 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $186.21 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $74.13 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $323.59 | Professional | 54 · Surgery only | $275.42 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $64.57 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $186.21 | $204.17 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $87.10 | Professional | 53 · Discontinued | $74.13 | $83.18 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $323.59 | Professional | 54 · Surgery only | $275.42 | $309.03 | $323.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $64.57 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $64.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $43.65 |
Where Pennsylvania sits
The same service costs 8.9 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· 40th of 51
$525
OK $2,754UT $309
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.