How much rates vary
Facilitymedian $4,898 · 10th to 90th $724 to $9,772Professionalmedian $871 · 10th to 90th $724 to $1,585
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 $660.69 Median $724.44 Typical High $870.96 | Professional | None | $660.69 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $512.86 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $512.86 | $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 $812.83 Median $1,380.38 Typical High $1,621.81 | Professional | None | $812.83 | $1,380.38 | $1,621.81 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $1,000.00 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $602.56 | $1,000.00 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $8,128.31 | Facility | None | $501.19 | $2,691.53 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,584.89 | Professional | None | $776.25 | $891.25 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,230.27 | Professional | None | $1,148.15 | $1,148.15 | $1,230.27 |
Geisinger Setting Facility Modifier None Typical Low $5,011.87 Median $6,165.95 Typical High $10,964.78 | Facility | None | $5,011.87 | $6,165.95 | $10,964.78 |
Geisinger Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,548.82 | Professional | None | $741.31 | $977.24 | $1,548.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $23,442.29 Typical High $39,810.72 | Facility | None | $3,890.45 | $23,442.29 | $39,810.72 |
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 $660.69 Median $724.44 Typical High $870.96 | Professional | None | $660.69 | $724.44 | $870.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $512.86 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $457.09 | $512.86 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $3,162.28 | Professional | None | $912.01 | $933.25 | $3,162.28 |
UPMC Health Plan Setting Facility Modifier None Typical Low $794.33 Median $891.25 Typical High $891.25 | Facility | None | $794.33 | $891.25 | $891.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | None | $794.33 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $10,715.19 | Facility | None | $1,698.24 | $3,235.94 | $10,715.19 |
United Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,659.59 | Professional | None | $741.31 | $954.99 | $1,659.59 |
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 $331.13 Median $363.08 Typical High $389.05 | Professional | 52 · Reduced service | $331.13 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $549.54 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $109.65 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $77.62 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $363.08 Typical High $389.05 | Professional | 52 · Reduced service | $331.13 | $363.08 | $389.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $144.54 | $154.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $549.54 Typical High $575.44 | Professional | 54 · Surgery only | $489.78 | $549.54 | $575.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $109.65 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $109.65 | $114.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $77.62 |
Where Pennsylvania sits
The same service costs 11.0 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· 41st of 51
$955
OK $5,888UT $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.