How much rates vary
Facilitymedian $832 · 10th to 90th $324 to $7,943Professionalmedian $776 · 10th to 90th $676 to $1,380
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 $645.65 Median $724.44 Typical High $794.33 | Professional | None | $645.65 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $537.03 |
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 $1,288.25 Median $1,288.25 Typical High $56,234.13 | Professional | None | $1,288.25 | $1,288.25 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $954.99 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $588.84 | $954.99 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $660.69 Typical High $2,290.87 | Facility | None | $380.19 | $660.69 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,548.82 | Professional | None | $741.31 | $912.01 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,122.02 | $1,122.02 | $1,202.26 |
Geisinger Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,548.82 | Professional | None | $707.95 | $954.99 | $1,548.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Facility | None | $8,317.64 | $8,317.64 | $8,317.64 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $5,248.07 Typical High $8,709.64 | Facility | None | $912.01 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $776.25 | Professional | None | $645.65 | $724.44 | $776.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,584.89 | Professional | None | $812.83 | $891.25 | $1,584.89 |
UPMC Health Plan Setting Facility Modifier None Typical Low $794.33 Median $851.14 Typical High $851.14 | Facility | None | $794.33 | $851.14 | $851.14 |
UPMC Health Plan Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | None | $794.33 | $851.14 | $851.14 |
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 $724.44 Median $933.25 Typical High $1,621.81 | Professional | None | $724.44 | $933.25 | $1,621.81 |
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 $323.59 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $75.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $354.81 | $380.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $144.54 | $151.36 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $537.03 | $575.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $114.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $75.86 |
Where Pennsylvania sits
The same service costs 6.2 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· 45th of 51
$794
AK $3,236UT $525
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.