How much rates vary
Facilitymedian $2,570 · 10th to 90th $676 to $8,318Professionalmedian $1,259 · 10th to 90th $1,023 to $2,291
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 $977.24 Median $1,096.48 Typical High $1,202.26 | Professional | None | $977.24 | $1,096.48 | $1,202.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $812.83 |
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 $1,202.26 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,949.84 | $2,398.83 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,445.44 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $891.25 | $1,445.44 | $1,778.28 |
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 $1,148.15 Median $1,318.26 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,318.26 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,819.70 | Professional | None | $1,698.24 | $1,698.24 | $1,819.70 |
Geisinger Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,479.11 | $2,454.71 |
Martin's Point Setting Facility Modifier None Typical Low $1,096.48 Median $5,248.07 Typical High $8,709.64 | Facility | None | $1,096.48 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,202.26 | Professional | None | $977.24 | $1,096.48 | $1,202.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $812.83 |
Oscar Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,412.54 | $2,454.71 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,318.26 | Facility | None | $1,023.29 | $1,202.26 | $1,318.26 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,202.26 | $1,318.26 |
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 $1,122.02 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,445.44 | $2,454.71 |
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 $489.78 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $489.78 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $218.78 Typical High $229.09 | Professional | 53 · Discontinued | $194.98 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $741.31 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $173.78 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $97.72 | $109.65 | $114.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $489.78 | $549.54 | $575.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $218.78 Typical High $229.09 | Professional | 53 · Discontinued | $194.98 | $218.78 | $229.09 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $741.31 | $812.83 | $870.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $173.78 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $173.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $97.72 | $109.65 | $114.82 |
Where Pennsylvania sits
The same service costs 7.2 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
$1,318
AK $4,898TX $676
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.