How much rates vary
Facilitymedian $1,778 · 10th to 90th $603 to $5,495Professionalmedian $427 · 10th to 90th $372 to $759
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 $354.81 Median $398.11 Typical High $489.78 | Professional | None | $354.81 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $288.40 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $56,234.13 | Professional | None | $691.83 | $691.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $524.81 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $323.59 | $524.81 | $676.08 |
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 $389.05 Median $489.78 Typical High $831.76 | Professional | None | $389.05 | $489.78 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $660.69 | Professional | None | $616.60 | $616.60 | $660.69 |
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 $380.19 Median $512.86 Typical High $851.14 | Professional | None | $380.19 | $512.86 | $851.14 |
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 $354.81 Median $398.11 Typical High $489.78 | Professional | None | $354.81 | $398.11 | $489.78 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $288.40 |
Oscar Health Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $831.76 | Professional | None | $467.74 | $489.78 | $831.76 |
UPMC Health Plan Setting Facility Modifier None Typical Low $426.58 Median $1,737.80 Typical High $3,388.44 | Facility | None | $426.58 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | None | $426.58 | $467.74 | $467.74 |
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 $389.05 Median $501.19 Typical High $851.14 | Professional | None | $389.05 | $501.19 | $851.14 |
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 $177.83 Median $194.98 Typical High $208.93 | Professional | 52 · Reduced service | $177.83 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $70.79 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $309.03 | Professional | 54 · Surgery only | $263.03 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $41.69 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $41.69 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $194.98 Typical High $208.93 | Professional | 52 · Reduced service | $177.83 | $194.98 | $208.93 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $70.79 | $79.43 | $83.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $309.03 | Professional | 54 · Surgery only | $263.03 | $295.12 | $309.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $61.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $41.69 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $41.69 |
Where Pennsylvania sits
The same service costs 7.1 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· 43rd of 51
$501
AK $2,042UT $288
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.