How much rates vary
Facilitymedian $2,692 · 10th to 90th $813 to $7,244Professionalmedian $575 · 10th to 90th $501 to $1,148
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 $5,495.41 Typical High $8,709.64 | Facility | None | $831.76 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $588.84 | Professional | None | $478.63 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $331.13 | $371.54 | $389.05 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,380.38 | Professional | None | $912.01 | $1,348.96 | $1,380.38 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $676.08 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $436.52 | $676.08 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,187.76 Typical High $3,801.89 | Facility | None | $707.95 | $2,187.76 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $1,148.15 | Professional | None | $537.03 | $602.56 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $891.25 | Professional | None | $831.76 | $831.76 | $891.25 |
Geisinger Setting Facility Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $4,897.79 | Facility | None | $2,238.72 | $2,754.23 | $4,897.79 |
Geisinger Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,148.15 | Professional | None | $524.81 | $691.83 | $1,148.15 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $4,897.79 Typical High $8,709.64 | Facility | None | $912.01 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $588.84 | Professional | None | $478.63 | $524.81 | $588.84 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $331.13 | $371.54 | $389.05 |
Oscar Health Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $1,148.15 | Professional | None | $676.08 | $707.95 | $1,148.15 |
UPMC Health Plan Setting Facility Modifier None Typical Low $575.44 Median $2,754.23 Typical High $5,495.41 | Facility | None | $575.44 | $2,754.23 | $5,495.41 |
UPMC Health Plan Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $660.69 | Professional | None | $575.44 | $660.69 | $660.69 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,148.15 | Professional | None | $537.03 | $676.08 | $1,148.15 |
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 $239.88 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $56.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $263.03 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $104.71 | $112.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $398.11 | $416.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $79.43 | $83.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $56.23 |
Where Pennsylvania sits
The same service costs 6.9 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· 41st of 51
$692
AK $2,754UT $398
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.