How much rates vary
Facilitymedian $1,820 · 10th to 90th $550 to $6,457Professionalmedian $537 · 10th to 90th $468 to $977
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 $812.83 Median $4,897.79 Typical High $8,511.38 | Facility | None | $812.83 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $602.56 | Professional | None | $446.68 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $363.08 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $56,234.13 | Professional | None | $676.08 | $676.08 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $407.38 | $645.65 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $660.69 Typical High $2,290.87 | Facility | None | $380.19 | $660.69 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $1,071.52 | Professional | None | $501.19 | $575.44 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $851.14 | Professional | None | $794.33 | $794.33 | $851.14 |
Geisinger Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,698.24 | Professional | None | $512.86 | $676.08 | $1,698.24 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $4,786.30 Typical High $8,511.38 | Facility | None | $831.76 | $4,786.30 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $602.56 | Professional | None | $446.68 | $489.78 | $602.56 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $363.08 |
Oscar Health Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $1,148.15 | Professional | None | $616.60 | $645.65 | $1,148.15 |
UPMC Health Plan Setting Facility Modifier None Typical Low $537.03 Median $2,187.76 Typical High $3,715.35 | Facility | None | $537.03 | $2,187.76 | $3,715.35 |
UPMC Health Plan Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | None | $537.03 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $3,890.45 | Facility | None | $1,148.15 | $1,819.70 | $3,890.45 |
United Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $1,096.48 | Professional | None | $489.78 | $630.96 | $1,096.48 |
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 $223.87 Median $245.47 Typical High $263.03 | Professional | 52 · Reduced service | $223.87 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $52.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $245.47 Typical High $263.03 | Professional | 52 · Reduced service | $223.87 | $245.47 | $263.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $89.13 | $97.72 | $104.71 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $371.54 | $389.05 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $77.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $52.48 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $52.48 |
Where Pennsylvania sits
The same service costs 6.0 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· 45th of 51
$575
AK $2,239UT $372
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.