How much rates vary
Facilitymedian $794 · 10th to 90th $302 to $6,166Professionalmedian $891 · 10th to 90th $741 to $1,479
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 $870.96 Median $1,513.56 Typical High $8,511.38 | Facility | None | $870.96 | $1,513.56 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,023.29 | Professional | None | $741.31 | $870.96 | $1,023.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $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 $1,445.44 Median $1,445.44 Typical High $56,234.13 | Professional | None | $1,445.44 | $1,445.44 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $537.03 | $870.96 | $1,000.00 |
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 $1,071.52 Typical High $1,659.59 | Professional | None | $851.14 | $1,071.52 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,288.25 | $1,445.44 |
Geisinger Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $2,754.23 | Professional | None | $831.76 | $1,122.02 | $2,754.23 |
Martin's Point Setting Facility Modifier None Typical Low $870.96 Median $1,584.89 Typical High $8,511.38 | Facility | None | $870.96 | $1,584.89 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $933.25 | Professional | None | $741.31 | $870.96 | $933.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,778.28 | Professional | None | $954.99 | $1,000.00 | $1,778.28 |
UPMC Health Plan Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $891.25 | Facility | None | $831.76 | $831.76 | $891.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $891.25 | Professional | None | $831.76 | $831.76 | $891.25 |
United Setting Facility Modifier None Typical Low $199.53 Median $562.34 Typical High $4,265.80 | Facility | None | $199.53 | $562.34 | $4,265.80 |
United Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,819.70 | Professional | None | $812.83 | $977.24 | $1,819.70 |
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 $371.54 Median $426.58 Typical High $436.52 | Professional | 52 · Reduced service | $371.54 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $147.91 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $74.13 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $426.58 | $426.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $147.91 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $645.65 | $645.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $74.13 | $87.10 | $87.10 |
Where Pennsylvania sits
The same service costs 6.6 times more in Alaska 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· 44th of 51
$891
AK $2,884TX $437
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.