How much rates vary
Facilitymedian $2,884 · 10th to 90th $676 to $8,511Professionalmedian $1,349 · 10th to 90th $1,175 to $2,512
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 $1,047.13 Median $5,495.41 Typical High $8,709.64 | Facility | None | $1,047.13 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,174.90 | $1,288.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $741.31 | $812.83 | $870.96 |
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 $1,318.26 Median $2,137.96 Typical High $2,570.40 | Professional | None | $1,318.26 | $2,137.96 | $2,570.40 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,548.82 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $977.24 | $1,548.82 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $5,128.61 | Facility | None | $501.19 | $2,691.53 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,412.54 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,949.84 | Professional | None | $1,819.70 | $1,819.70 | $1,949.84 |
Geisinger Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,691.53 | Professional | None | $1,174.90 | $1,584.89 | $2,691.53 |
Highmark BCBS Setting Facility Modifier None Typical Low $26,302.68 Median $26,302.68 Typical High $26,302.68 | Facility | None | $26,302.68 | $26,302.68 | $26,302.68 |
Martin's Point Setting Facility Modifier None Typical Low $1,148.15 Median $5,248.07 Typical High $8,709.64 | Facility | None | $1,148.15 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,174.90 | $1,288.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $741.31 | $812.83 | $870.96 |
Oscar Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,479.11 | $1,513.56 | $2,630.27 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,288.25 | $1,445.44 | $1,445.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,445.44 | $1,445.44 |
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 $1,202.26 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,548.82 | $2,691.53 |
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 $537.03 Median $588.84 Typical High $616.60 | Professional | 52 · Reduced service | $537.03 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $234.42 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $794.33 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $158.49 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $117.49 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $117.49 | $125.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $588.84 Typical High $616.60 | Professional | 52 · Reduced service | $537.03 | $588.84 | $616.60 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $234.42 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $234.42 | $251.19 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $794.33 | $870.96 | $933.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $158.49 | $173.78 | $186.21 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $117.49 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $117.49 | $125.89 |
UPMC Health Plan Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 62 · Two surgeons | $1,122.02 | $1,174.90 | $1,174.90 |
Where Pennsylvania sits
The same service costs 6.9 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· 43rd of 51
$1,445
AK $5,370TX $776
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.