How much rates vary
Facilitymedian $3,311 · 10th to 90th $724 to $7,762Professionalmedian $589 · 10th to 90th $537 to $1,096
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 $4,786.30 Typical High $8,511.38 | Facility | None | $812.83 | $4,786.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $660.69 | Professional | None | $537.03 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $416.87 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $56,234.13 | Professional | None | $954.99 | $954.99 | $56,234.13 |
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 $616.60 Median $2,818.38 Typical High $4,897.79 | Facility | None | $616.60 | $2,818.38 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $1,202.26 | Professional | None | $537.03 | $616.60 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $891.25 | Professional | None | $831.76 | $831.76 | $891.25 |
Geisinger Setting Facility Modifier None Typical Low $2,951.21 Median $3,715.35 Typical High $6,456.54 | Facility | None | $2,951.21 | $3,715.35 | $6,456.54 |
Geisinger Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,148.15 | Professional | None | $537.03 | $707.95 | $1,148.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $12,302.69 | Facility | None | $7,244.36 | $7,244.36 | $12,302.69 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $4,570.88 Typical High $8,511.38 | Facility | None | $831.76 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $660.69 | Professional | None | $537.03 | $588.84 | $660.69 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $416.87 |
Oscar Health Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $1,148.15 | Professional | None | $676.08 | $707.95 | $1,148.15 |
UPMC Health Plan Setting Facility Modifier None Typical Low $562.34 Median $2,137.96 Typical High $4,168.69 | Facility | None | $562.34 | $2,137.96 | $4,168.69 |
UPMC Health Plan Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $588.84 | Professional | None | $562.34 | $562.34 | $588.84 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $8,511.38 | Facility | None | $1,698.24 | $3,235.94 | $8,511.38 |
United Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,148.15 | Professional | None | $562.34 | $645.65 | $1,148.15 |
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 $269.15 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $269.15 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $120.23 | Professional | 53 · Discontinued | $107.15 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $407.38 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $60.26 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $269.15 | $295.12 | $295.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $120.23 | Professional | 53 · Discontinued | $107.15 | $117.49 | $120.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $407.38 | $446.68 | $446.68 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $60.26 |
Where Pennsylvania sits
The same service costs 8.1 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· 45th of 51
$661
OK $3,467UT $427
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.