How much rates vary
Facilitymedian $1,905 · 10th to 90th $776 to $5,754Professionalmedian $372 · 10th to 90th $324 to $692
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 $3,235.94 Typical High $8,511.38 | Facility | None | $645.65 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $407.38 | Professional | None | $302.00 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $234.42 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $208.93 | $234.42 | $245.47 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $8,709.64 | Facility | None | $3,981.07 | $7,413.10 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $870.96 | Professional | None | $588.84 | $616.60 | $870.96 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $275.42 | $436.52 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,737.80 Typical High $3,235.94 | Facility | None | $691.83 | $1,737.80 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $724.44 | Professional | None | $346.74 | $389.05 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | None | $524.81 | $524.81 | $575.44 |
Geisinger Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $3,715.35 | Facility | None | $1,698.24 | $2,089.30 | $3,715.35 |
Geisinger Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $724.44 | Professional | None | $338.84 | $446.68 | $724.44 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,818.38 Typical High $8,511.38 | Facility | None | $724.44 | $2,818.38 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $407.38 | Professional | None | $302.00 | $331.13 | $407.38 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $234.42 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $208.93 | $234.42 | $245.47 |
Oscar Health Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $724.44 | Professional | None | $323.59 | $407.38 | $724.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $363.08 Median $3,388.44 Typical High $6,606.93 | Facility | None | $363.08 | $3,388.44 | $6,606.93 |
UPMC Health Plan Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $371.54 | Professional | None | $363.08 | $371.54 | $371.54 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,466.84 | Facility | None | $812.83 | $1,318.26 | $4,466.84 |
United Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $741.31 | Professional | None | $338.84 | $426.58 | $741.31 |
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 $151.36 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $151.36 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $251.19 Typical High $263.03 | Professional | 54 · Surgery only | $223.87 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $50.12 Typical High $52.48 | Professional | 55 · Aftercare only | $44.67 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $35.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $151.36 | $165.96 | $173.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $66.07 | $70.79 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $251.19 Typical High $263.03 | Professional | 54 · Surgery only | $223.87 | $251.19 | $263.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $50.12 Typical High $52.48 | Professional | 55 · Aftercare only | $44.67 | $50.12 | $52.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $35.48 |
Where Pennsylvania sits
The same service costs 7.1 times more in Oklahoma 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
$437
OK $1,950UT $275
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.