How much rates vary
Facilitymedian $741 · 10th to 90th $240 to $6,310Professionalmedian $794 · 10th to 90th $708 to $1,413
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 $741.31 Median $4,897.79 Typical High $8,511.38 | Facility | None | $741.31 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $812.83 | Professional | None | $676.08 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $524.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $524.81 | $549.54 |
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 $1,318.26 Median $1,318.26 Typical High $56,234.13 | Professional | None | $1,318.26 | $1,318.26 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $1,000.00 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $616.60 | $1,000.00 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $676.08 Typical High $2,290.87 | Facility | None | $120.23 | $676.08 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,621.81 | Professional | None | $776.25 | $912.01 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,258.93 | Professional | None | $1,174.90 | $1,174.90 | $1,258.93 |
Geisinger Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,621.81 | Professional | None | $758.58 | $1,000.00 | $1,621.81 |
Martin's Point Setting Facility Modifier None Typical Low $741.31 Median $3,801.89 Typical High $8,709.64 | Facility | None | $741.31 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $794.33 | Professional | None | $676.08 | $741.31 | $794.33 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $524.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $524.81 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,659.59 | Professional | None | $891.25 | $933.25 | $1,659.59 |
UPMC Health Plan Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $812.83 | Facility | None | $758.58 | $758.58 | $812.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $812.83 | Professional | None | $758.58 | $758.58 | $812.83 |
United Setting Facility Modifier None Typical Low $199.53 Median $562.34 Typical High $4,265.80 | Facility | None | $199.53 | $562.34 | $4,265.80 |
United Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,659.59 | Professional | None | $758.58 | $977.24 | $1,659.59 |
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 $338.84 Median $371.54 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $147.91 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $562.34 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $74.13 Typical High $79.43 | Professional | 56 · Pre-op care only | $67.61 | $74.13 | $79.43 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $371.54 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $371.54 | $398.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $147.91 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $147.91 | $158.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $562.34 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $562.34 | $588.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $117.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $74.13 Typical High $79.43 | Professional | 56 · Pre-op care only | $67.61 | $74.13 | $79.43 |
Where Pennsylvania sits
The same service costs 6.3 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· 48th of 51
$794
AK $3,388UT $537
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.