How much rates vary
Facilitymedian $1,660 · 10th to 90th $603 to $6,457Professionalmedian $813 · 10th to 90th $692 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 $812.83 Median $4,897.79 Typical High $8,511.38 | Facility | None | $812.83 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $851.14 | Professional | None | $676.08 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $549.54 |
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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $489.78 | $794.33 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $676.08 Typical High $2,290.87 | Facility | None | $120.23 | $676.08 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,513.56 | Professional | None | $776.25 | $977.24 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,148.15 | $1,318.26 |
Geisinger Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,584.89 | Professional | None | $741.31 | $1,000.00 | $1,584.89 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $4,786.30 Typical High $8,511.38 | Facility | None | $831.76 | $4,786.30 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $851.14 | Professional | None | $676.08 | $776.25 | $851.14 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,621.81 | Professional | None | $851.14 | $912.01 | $1,621.81 |
UPMC Health Plan Setting Facility Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,862.09 | Facility | None | $812.83 | $1,148.15 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $741.31 Median $891.25 Typical High $1,621.81 | Professional | None | $741.31 | $891.25 | $1,621.81 |
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 $338.84 Median $389.05 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $77.62 Typical High $79.43 | Professional | 56 · Pre-op care only | $67.61 | $77.62 | $79.43 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $389.05 | $389.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $588.84 | $588.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $117.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $77.62 | $77.62 |
Where Pennsylvania sits
The same service costs 8.5 times more in Oklahoma than in Texas. 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
$851
OK $3,162TX $372
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.