How much rates vary
Facilitymedian $1,778 · 10th to 90th $617 to $5,495Professionalmedian $339 · 10th to 90th $295 to $603
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 $676.08 Median $3,890.45 Typical High $8,317.64 | Facility | None | $676.08 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $354.81 | Professional | None | $275.42 | $309.03 | $354.81 |
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 $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 $338.84 Median $537.03 Typical High $602.56 | Professional | None | $338.84 | $537.03 | $602.56 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $251.19 | $389.05 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $2,818.38 | Facility | None | $501.19 | $1,659.59 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $630.96 | Professional | None | $295.12 | $331.13 | $630.96 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $524.81 | Professional | None | $489.78 | $489.78 | $524.81 |
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 $309.03 Median $416.87 Typical High $977.24 | Professional | None | $309.03 | $416.87 | $977.24 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $354.81 | Professional | None | $275.42 | $309.03 | $354.81 |
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 $338.84 Median $380.19 Typical High $630.96 | Professional | None | $338.84 | $380.19 | $630.96 |
UPMC Health Plan Setting Facility Modifier None Typical Low $331.13 Median $1,737.80 Typical High $3,388.44 | Facility | None | $331.13 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $302.00 Median $380.19 Typical High $645.65 | Professional | None | $302.00 | $380.19 | $645.65 |
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 $138.04 Median $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $138.04 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $61.66 | $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 $30.90 Typical High $32.36 | Professional | 56 · Pre-op care only | $27.54 | $30.90 | $32.36 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $794.33 Typical High $912.01 | Professional | 50 · Both sides | $501.19 | $794.33 | $912.01 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $138.04 | $154.88 | $162.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $61.66 | $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 $30.90 Typical High $32.36 | Professional | 56 · Pre-op care only | $27.54 | $30.90 | $32.36 |
Where Pennsylvania sits
The same service costs 11.7 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· 40th of 51
$407
OK $2,754UT $234
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.