How much rates vary
Facilitymedian $813 · 10th to 90th $398 to $5,754Professionalmedian $331 · 10th to 90th $295 to $575
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 $588.84 Median $3,235.94 Typical High $8,511.38 | Facility | None | $588.84 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $426.58 | Professional | None | $275.42 | $302.00 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $213.80 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $190.55 | $213.80 | $223.87 |
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 $537.03 Median $537.03 Typical High $56,234.13 | Professional | None | $537.03 | $537.03 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $407.38 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $251.19 | $407.38 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $676.08 Typical High $2,290.87 | Facility | None | $380.19 | $676.08 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $645.65 | Professional | None | $316.23 | $346.74 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | None | $478.63 | $478.63 | $512.86 |
Geisinger Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $660.69 | Professional | None | $309.03 | $407.38 | $660.69 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,818.38 Typical High $8,317.64 | Facility | None | $724.44 | $2,818.38 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $426.58 | Professional | None | $275.42 | $302.00 | $426.58 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $213.80 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $190.55 | $213.80 | $223.87 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $660.69 | Professional | None | $288.40 | $354.81 | $660.69 |
UPMC Health Plan Setting Facility Modifier None Typical Low $331.13 Median $346.74 Typical High $346.74 | Facility | None | $331.13 | $346.74 | $346.74 |
UPMC Health Plan Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | None | $331.13 | $346.74 | $346.74 |
United Setting Facility Modifier None Typical Low $416.87 Median $707.95 Typical High $2,398.83 | Facility | None | $416.87 | $707.95 | $2,398.83 |
United Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $660.69 | Professional | None | $302.00 | $389.05 | $660.69 |
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 $138.04 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $138.04 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $239.88 | Professional | 54 · Surgery only | $204.17 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $47.86 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $32.36 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $138.04 | $151.36 | $158.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $60.26 | $64.57 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $239.88 | Professional | 54 · Surgery only | $204.17 | $229.09 | $239.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $47.86 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $47.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $32.36 |
Where Pennsylvania sits
The same service costs 5.8 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· 46th of 51
$355
AK $1,380UT $240
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.