How much rates vary
Facilitymedian $2,239 · 10th to 90th $575 to $6,026Professionalmedian $468 · 10th to 90th $398 to $871
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 $645.65 Median $3,090.30 Typical High $8,511.38 | Facility | None | $645.65 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $467.74 | Professional | None | $398.11 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $323.59 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $870.96 | Professional | None | $776.25 | $851.14 | $870.96 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $537.03 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $371.54 | $537.03 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $3,715.35 | Facility | None | $478.63 | $2,137.96 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $912.01 | Professional | None | $416.87 | $478.63 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | None | $676.08 | $676.08 | $691.83 |
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 $426.58 Median $524.81 Typical High $851.14 | Professional | None | $426.58 | $524.81 | $851.14 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $8,317.64 | Facility | None | $724.44 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $467.74 | Professional | None | $398.11 | $436.52 | $467.74 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $316.23 |
Oscar Health Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $912.01 | Professional | None | $467.74 | $489.78 | $912.01 |
UPMC Health Plan Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $489.78 | Facility | None | $398.11 | $398.11 | $489.78 |
UPMC Health Plan Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | None | $398.11 | $398.11 | $489.78 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $6,025.60 | Facility | None | $812.83 | $1,318.26 | $6,025.60 |
United Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $933.25 | Professional | None | $426.58 | $537.03 | $933.25 |
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 $199.53 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $199.53 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $93.33 | Professional | 53 · Discontinued | $79.43 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $346.74 | Professional | 54 · Surgery only | $295.12 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $66.07 Typical High $69.18 | Professional | 55 · Aftercare only | $58.88 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $46.77 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $218.78 Typical High $223.87 | Professional | 52 · Reduced service | $199.53 | $218.78 | $223.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $89.13 | Professional | 53 · Discontinued | $79.43 | $87.10 | $89.13 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $323.59 | $338.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $66.07 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $66.07 | $67.61 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $44.67 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $44.67 |
Where Pennsylvania sits
The same service costs 6.5 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
$490
AK $1,995TX $309
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.