How much rates vary
Facilitymedian $794 · 10th to 90th $339 to $6,166Professionalmedian $457 · 10th to 90th $389 to $776
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 $588.84 Median $3,235.94 Typical High $8,511.38 | Facility | None | $588.84 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $512.86 | Professional | None | $380.19 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $269.15 | $316.23 | $316.23 |
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 $741.31 Median $741.31 Typical High $56,234.13 | Professional | None | $741.31 | $741.31 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $275.42 | $436.52 | $524.81 |
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 $446.68 Median $549.54 Typical High $870.96 | Professional | None | $446.68 | $549.54 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | None | $660.69 | $660.69 | $741.31 |
Geisinger Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $912.01 | Professional | None | $416.87 | $562.34 | $912.01 |
Highmark BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Facility | None | $11,481.54 | $11,481.54 | $11,481.54 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,818.38 Typical High $8,317.64 | Facility | None | $724.44 | $2,818.38 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $501.19 | Professional | None | $380.19 | $446.68 | $501.19 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $269.15 | $316.23 | $316.23 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $891.25 | Professional | None | $489.78 | $524.81 | $891.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $457.09 Median $645.65 Typical High $1,047.13 | Facility | None | $457.09 | $645.65 | $1,047.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $416.87 Median $489.78 Typical High $912.01 | Professional | None | $416.87 | $489.78 | $912.01 |
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 $190.55 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $190.55 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $288.40 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.02 | $44.67 | $44.67 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $190.55 | $223.87 | $223.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $288.40 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.02 | $44.67 | $44.67 |
Where Pennsylvania sits
The same service costs 7.4 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· 44th of 51
$468
OK $2,089UT $282
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.