How much rates vary
Facilitymedian $1,862 · 10th to 90th $589 to $8,511Professionalmedian $933 · 10th to 90th $813 to $1,778
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 $741.31 Median $812.83 Typical High $891.25 | Professional | None | $741.31 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $602.56 |
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 $912.01 Median $1,479.11 Typical High $1,905.46 | Professional | None | $912.01 | $1,479.11 | $1,905.46 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,096.48 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $676.08 | $1,096.48 | $1,412.54 |
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 $851.14 Median $1,047.13 Typical High $1,778.28 | Professional | None | $851.14 | $1,047.13 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,258.93 | $1,380.38 |
Geisinger Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,819.70 | Professional | None | $812.83 | $1,096.48 | $1,819.70 |
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 $741.31 Median $812.83 Typical High $891.25 | Professional | None | $741.31 | $812.83 | $891.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,071.52 | $1,819.70 |
UPMC Health Plan Setting Facility Modifier None Typical Low $851.14 Median $9,120.11 Typical High $14,791.08 | Facility | None | $851.14 | $9,120.11 | $14,791.08 |
UPMC Health Plan Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | None | $851.14 | $851.14 | $891.25 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $3,890.45 | Facility | None | $1,148.15 | $1,862.09 | $3,890.45 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,819.70 | Professional | None | $831.76 | $1,071.52 | $1,819.70 |
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 $371.54 Median $407.38 Typical High $436.52 | Professional | 52 · Reduced service | $371.54 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $173.78 | Professional | 53 · Discontinued | $147.91 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $549.54 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $128.82 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $87.10 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $2,187.76 Typical High $2,884.03 | Professional | 50 · Both sides | $1,348.96 | $2,187.76 | $2,884.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $407.38 Typical High $436.52 | Professional | 52 · Reduced service | $371.54 | $407.38 | $436.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $173.78 | Professional | 53 · Discontinued | $147.91 | $162.18 | $173.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $549.54 | $616.60 | $645.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $128.82 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $87.10 |
Where Pennsylvania sits
The same service costs 6.3 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· 44th of 51
$977
AK $3,715UT $589
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.