How much rates vary
Facilitymedian $2,291 · 10th to 90th $617 to $6,310Professionalmedian $617 · 10th to 90th $525 to $1,023
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 $562.34 Median $4,897.79 Typical High $8,511.38 | Facility | None | $562.34 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $602.56 | Professional | None | $501.19 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $407.38 |
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 $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $724.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $457.09 | $724.44 | $870.96 |
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 $562.34 Median $645.65 Typical High $1,202.26 | Professional | None | $562.34 | $645.65 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $933.25 | Professional | None | $870.96 | $870.96 | $933.25 |
Geisinger Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,202.26 | Professional | None | $562.34 | $741.31 | $1,202.26 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Martin's Point Setting Facility Modifier None Typical Low $562.34 Median $3,801.89 Typical High $8,709.64 | Facility | None | $562.34 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $588.84 | Professional | None | $501.19 | $562.34 | $588.84 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $407.38 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,202.26 | Professional | None | $707.95 | $776.25 | $1,202.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $616.60 Median $2,884.03 Typical High $4,786.30 | Facility | None | $616.60 | $2,884.03 | $4,786.30 |
UPMC Health Plan Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | None | $616.60 | $724.44 | $724.44 |
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 $562.34 Median $724.44 Typical High $1,230.27 | Professional | None | $562.34 | $724.44 | $1,230.27 |
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 $251.19 Median $275.42 Typical High $295.12 | Professional | 52 · Reduced service | $251.19 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $436.52 | Professional | 54 · Surgery only | $380.19 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $58.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $275.42 Typical High $295.12 | Professional | 52 · Reduced service | $251.19 | $275.42 | $295.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $112.20 | $117.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $436.52 | Professional | 54 · Surgery only | $380.19 | $416.87 | $436.52 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $89.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $58.88 |
Where Pennsylvania sits
The same service costs 6.2 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· 46th of 51
$646
AK $2,512UT $407
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.