How much rates vary
Facilitymedian $1,698 · 10th to 90th $380 to $4,898Professionalmedian $219 · 10th to 90th $166 to $355
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 $223.87 Median $1,995.26 Typical High $7,943.28 | Facility | None | $223.87 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $223.87 | Professional | None | $158.49 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $141.25 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $109.65 | $141.25 | $158.49 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,981.07 | $6,025.60 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $426.58 | Professional | None | $239.88 | $239.88 | $426.58 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $281.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $190.55 | $281.84 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,621.81 Typical High $2,818.38 | Facility | None | $338.84 | $1,621.81 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $389.05 | Professional | None | $162.18 | $208.93 | $389.05 |
Emblem Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | None | $389.05 | $389.05 | $416.87 |
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 $181.97 Median $257.04 Typical High $407.38 | Professional | None | $181.97 | $257.04 | $407.38 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $6,606.93 Typical High $26,302.68 | Facility | None | $2,187.76 | $6,606.93 | $26,302.68 |
Martin's Point Setting Facility Modifier None Typical Low $309.03 Median $1,995.26 Typical High $6,606.93 | Facility | None | $309.03 | $1,995.26 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $223.87 | Professional | None | $151.36 | $199.53 | $223.87 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $138.04 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $104.71 | $138.04 | $158.49 |
Oscar Health Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $436.52 | Professional | None | $257.04 | $281.84 | $436.52 |
UPMC Health Plan Setting Facility Modifier None Typical Low $239.88 Median $812.83 Typical High $1,862.09 | Facility | None | $239.88 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $269.15 | Professional | None | $181.97 | $239.88 | $269.15 |
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 $173.78 Median $229.09 Typical High $398.11 | Professional | None | $173.78 | $229.09 | $398.11 |
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 $79.43 Median $100.00 Typical High $112.20 | Professional | 52 · Reduced service | $79.43 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $39.81 Typical High $45.71 | Professional | 53 · Discontinued | $31.62 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $151.36 Typical High $169.82 | Professional | 54 · Surgery only | $117.49 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.20 Typical High $33.88 | Professional | 55 · Aftercare only | $23.44 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.85 | $19.95 | $22.39 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $100.00 Typical High $112.20 | Professional | 52 · Reduced service | $74.13 | $100.00 | $112.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $39.81 Typical High $45.71 | Professional | 53 · Discontinued | $30.20 | $39.81 | $45.71 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $147.91 Typical High $169.82 | Professional | 54 · Surgery only | $112.20 | $147.91 | $169.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $22.39 | $29.51 | $33.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.14 | $19.95 | $22.39 |
Where Pennsylvania sits
The same service costs 4.4 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· 47th of 51
$229
AK $871UT $200
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.