How much rates vary
Facilitymedian $3,236 · 10th to 90th $832 to $8,128Professionalmedian $759 · 10th to 90th $646 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 $588.84 Median $660.69 Typical High $758.58 | Professional | None | $588.84 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $416.87 | $457.09 | $489.78 |
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 $724.44 Median $1,174.90 Typical High $1,445.44 | Professional | None | $724.44 | $1,174.90 | $1,445.44 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $933.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $588.84 | $933.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,412.54 | Professional | None | $691.83 | $776.25 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Professional | None | $1,023.29 | $1,023.29 | $1,096.48 |
Geisinger Setting Facility Modifier None Typical Low $2,951.21 Median $3,715.35 Typical High $6,456.54 | Facility | None | $2,951.21 | $3,715.35 | $6,456.54 |
Geisinger Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,513.56 | Professional | None | $660.69 | $891.25 | $1,513.56 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $4,897.79 Typical High $8,709.64 | Facility | None | $912.01 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $724.44 | Professional | None | $588.84 | $660.69 | $724.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $416.87 | $457.09 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,479.11 | Professional | None | $831.76 | $912.01 | $1,479.11 |
UPMC Health Plan Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $4,168.69 | Facility | None | $724.44 | $2,137.96 | $4,168.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $831.76 | Professional | None | $724.44 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $8,511.38 | Facility | None | $1,698.24 | $3,235.94 | $8,511.38 |
United Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,479.11 | Professional | None | $676.08 | $870.96 | $1,479.11 |
11 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 $295.12 Median $323.59 Typical High $346.74 | Professional | 52 · Reduced service | $295.12 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $489.78 Typical High $524.81 | Professional | 54 · Surgery only | $446.68 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $104.71 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $66.07 | $69.18 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,778.28 Typical High $2,137.96 | Professional | 50 · Both sides | $1,096.48 | $1,778.28 | $2,137.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $323.59 Typical High $346.74 | Professional | 52 · Reduced service | $295.12 | $323.59 | $346.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $131.83 | $138.04 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $489.78 Typical High $524.81 | Professional | 54 · Surgery only | $446.68 | $489.78 | $524.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $104.71 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $104.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $66.07 | $69.18 |
Where Pennsylvania sits
The same service costs 6.5 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
$871
AK $3,467UT $537
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.