How much rates vary
Facilitymedian $832 · 10th to 90th $380 to $3,890Professionalmedian $166 · 10th to 90th $138 to $302
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 $186.21 Median $2,137.96 Typical High $8,317.64 | Facility | None | $186.21 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $186.21 | Professional | None | $138.04 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $114.82 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $97.72 | $114.82 | $128.82 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $56,234.13 | Facility | None | $2,630.27 | $3,019.95 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $56,234.13 | Professional | None | $245.47 | $245.47 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $213.80 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $147.91 | $213.80 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $645.65 Typical High $1,258.93 | Facility | None | $338.84 | $645.65 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $346.74 | Professional | None | $131.83 | $177.83 | $346.74 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | None | $302.00 | $302.00 | $316.23 |
Geisinger Setting Facility Modifier None Typical Low $645.65 Median $794.33 Typical High $1,412.54 | Facility | None | $645.65 | $794.33 | $1,412.54 |
Geisinger Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $316.23 | Professional | None | $141.25 | $199.53 | $316.23 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $7,244.36 | Facility | None | $478.63 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $186.21 | Professional | None | $138.04 | $165.96 | $186.21 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $114.82 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $97.72 | $114.82 | $128.82 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $331.13 | Professional | None | $169.82 | $181.97 | $331.13 |
UPMC Health Plan Setting Facility Modifier None Typical Low $144.54 Median $812.83 Typical High $1,862.09 | Facility | None | $144.54 | $812.83 | $1,862.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $181.97 | Professional | None | $144.54 | $151.36 | $181.97 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,467.37 | Facility | None | $416.87 | $724.44 | $3,467.37 |
United Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $323.59 | Professional | None | $151.36 | $181.97 | $323.59 |
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 $69.18 Median $83.18 Typical High $93.33 | Professional | 52 · Reduced service | $69.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.11 Typical High $37.15 | Professional | 53 · Discontinued | $28.18 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $138.04 | Professional | 54 · Surgery only | $104.71 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $27.54 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.60 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.80 | $16.60 | $18.62 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $83.18 Typical High $93.33 | Professional | 52 · Reduced service | $69.18 | $83.18 | $93.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.11 Typical High $37.15 | Professional | 53 · Discontinued | $28.18 | $33.11 | $37.15 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $138.04 | Professional | 54 · Surgery only | $104.71 | $123.03 | $138.04 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $27.54 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $27.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.60 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.80 | $16.60 | $18.62 |
Where Pennsylvania sits
The same service costs 4.6 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· 45th of 51
$182
AK $759UT $166
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.