How much rates vary
Facilitymedian $676 · 10th to 90th $240 to $6,310Professionalmedian $427 · 10th to 90th $363 to $741
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 $407.38 Median $4,897.79 Typical High $8,511.38 | Facility | None | $407.38 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $575.44 | Professional | None | $346.74 | $407.38 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $281.84 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $245.47 | $281.84 | $288.40 |
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 $707.95 Median $707.95 Typical High $1,023.29 | Professional | None | $707.95 | $707.95 | $1,023.29 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $257.04 | $407.38 | $489.78 |
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 $407.38 Median $501.19 Typical High $794.33 | Professional | None | $407.38 | $501.19 | $794.33 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | None | $616.60 | $616.60 | $691.83 |
Geisinger Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $831.76 | Professional | None | $389.05 | $524.81 | $831.76 |
Martin's Point Setting Facility Modifier None Typical Low $537.03 Median $3,801.89 Typical High $8,709.64 | Facility | None | $537.03 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $575.44 | Professional | None | $346.74 | $407.38 | $575.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $281.84 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $245.47 | $281.84 | $281.84 |
Oscar Health Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $851.14 | Professional | None | $467.74 | $489.78 | $851.14 |
UPMC Health Plan Setting Facility Modifier None Typical Low $416.87 Median $436.52 Typical High $436.52 | Facility | None | $416.87 | $436.52 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | None | $416.87 | $436.52 | $436.52 |
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 $389.05 Median $467.74 Typical High $851.14 | Professional | None | $389.05 | $467.74 | $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 $173.78 Median $204.17 Typical High $208.93 | Professional | 52 · Reduced service | $173.78 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $81.28 Typical High $83.18 | Professional | 53 · Discontinued | $69.18 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $302.00 Typical High $309.03 | Professional | 54 · Surgery only | $263.03 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $40.74 Typical High $41.69 | Professional | 56 · Pre-op care only | $34.67 | $40.74 | $41.69 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $173.78 | $204.17 | $204.17 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $81.28 | $81.28 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $263.03 | $302.00 | $302.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $61.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $34.67 | $40.74 | $40.74 |
Where Pennsylvania sits
The same service costs 5.0 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
$437
AK $1,349UT $269
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.