How much rates vary
Facilitymedian $1,778 · 10th to 90th $661 to $6,310Professionalmedian $1,148 · 10th to 90th $1,000 to $2,188
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 $831.76 Median $4,073.80 Typical High $8,511.38 | Facility | None | $831.76 | $4,073.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,230.27 | Professional | None | $954.99 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $660.69 | $741.31 | $776.25 |
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 $1,000.00 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,000.00 | $2,137.96 | $2,238.72 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,412.54 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $870.96 | $1,412.54 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,137.96 Typical High $3,715.35 | Facility | None | $501.19 | $2,137.96 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,230.27 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,778.28 | Professional | None | $1,621.81 | $1,621.81 | $1,778.28 |
Geisinger Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,412.54 | $2,290.87 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $8,317.64 | Facility | None | $831.76 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,230.27 | Professional | None | $954.99 | $1,047.13 | $1,230.27 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $660.69 | $741.31 | $776.25 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,318.26 | $2,344.23 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,148.15 | $1,174.90 | $1,174.90 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,148.15 | $1,174.90 | $1,174.90 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $6,025.60 | Facility | None | $812.83 | $1,318.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,380.38 | $2,344.23 |
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 $478.63 Median $524.81 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $190.55 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $707.95 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $112.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $524.81 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $524.81 | $562.34 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $190.55 | $208.93 | $223.87 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $707.95 | $794.33 | $831.76 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $165.96 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $112.20 |
Where Pennsylvania sits
The same service costs 4.4 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.
Physician feeFacility fee
AK $10,675KY $2,405
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.