How much rates vary
Facilitymedian $2,188 · 10th to 90th $631 to $7,413Professionalmedian $741 · 10th to 90th $661 to $1,288
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 $676.08 Median $4,897.79 Typical High $8,511.38 | Facility | None | $676.08 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $741.31 | Professional | None | $616.60 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $478.63 | $501.19 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $56,234.13 | Professional | None | $1,202.26 | $1,202.26 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $562.34 | $912.01 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $5,128.61 | Facility | None | $501.19 | $2,691.53 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,479.11 | Professional | None | $724.44 | $794.33 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,148.15 | Professional | None | $1,096.48 | $1,096.48 | $1,148.15 |
Geisinger Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,479.11 | Professional | None | $707.95 | $933.25 | $1,479.11 |
Martin's Point Setting Facility Modifier None Typical Low $676.08 Median $3,801.89 Typical High $8,709.64 | Facility | None | $676.08 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $724.44 | Professional | None | $616.60 | $676.08 | $724.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $478.63 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $478.63 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,584.89 | Professional | None | $870.96 | $933.25 | $1,584.89 |
UPMC Health Plan Setting Facility Modifier None Typical Low $741.31 Median $831.76 Typical High $831.76 | Facility | None | $741.31 | $831.76 | $831.76 |
UPMC Health Plan Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | None | $741.31 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,513.56 | Professional | None | $691.83 | $891.25 | $1,513.56 |
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 $309.03 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $72.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $338.84 | $363.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $134.90 | $144.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $512.86 | $537.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $107.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $72.44 |
Where Pennsylvania sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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
$794
OK $3,548TX $525
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.