How much rates vary
Facilitymedian $1,000 · 10th to 90th $316 to $8,511Professionalmedian $1,230 · 10th to 90th $1,023 to $2,138
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 $1,096.48 Median $5,754.40 Typical High $10,471.29 | Facility | None | $1,096.48 | $5,754.40 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,096.48 | $1,288.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $831.76 |
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 $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,995.26 | $1,995.26 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,479.11 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $912.01 | $1,479.11 | $1,819.70 |
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 $1,174.90 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,348.96 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,862.09 | Professional | None | $1,698.24 | $1,698.24 | $1,862.09 |
Geisinger Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,513.56 | $2,511.89 |
Martin's Point Setting Facility Modifier None Typical Low $1,096.48 Median $5,370.32 Typical High $10,964.78 | Facility | None | $1,096.48 | $5,370.32 | $10,964.78 |
Martin's Point Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,096.48 | $1,288.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $831.76 |
Oscar Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,380.38 | $2,511.89 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,230.27 | $1,348.96 | $1,348.96 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,230.27 | $1,348.96 | $1,348.96 |
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 $1,148.15 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,479.11 | $2,511.89 |
11 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 $501.19 Median $549.54 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $549.54 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $831.76 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $117.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $549.54 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $549.54 | $588.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $218.78 | $234.42 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $831.76 | $891.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $177.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $117.49 |
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 62 · Two surgeons | $1,202.26 | $1,202.26 | $1,202.26 |
Where Pennsylvania sits
The same service costs 7.1 times more in Alaska 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· 44th of 51
$1,202
AK $5,012TX $708
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.