How much rates vary
Facilitymedian $2,089 · 10th to 90th $631 to $6,918Professionalmedian $1,072 · 10th to 90th $759 to $1,738
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 $831.76 Median $3,801.89 Typical High $8,511.38 | Facility | None | $831.76 | $3,801.89 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,071.52 | Professional | None | $891.25 | $1,047.13 | $1,071.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $616.60 | $741.31 | $741.31 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $56,234.13 | Professional | None | $1,659.59 | $1,659.59 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,258.93 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $794.33 | $1,258.93 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,412.54 Typical High $2,454.71 | Facility | None | $501.19 | $1,412.54 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $2,137.96 | Professional | None | $758.58 | $1,122.02 | $2,137.96 |
Emblem Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,659.59 | $1,659.59 | $1,905.46 |
Geisinger Setting Professional Modifier None Typical Low $758.58 Median $1,288.25 Typical High $1,995.26 | Professional | None | $758.58 | $1,288.25 | $1,995.26 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $8,709.64 | Facility | None | $831.76 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,071.52 | Professional | None | $891.25 | $1,047.13 | $1,071.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $616.60 | $741.31 | $741.31 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,778.28 | Professional | None | $831.76 | $1,000.00 | $1,778.28 |
UPMC Health Plan Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $1,023.29 | Facility | None | $724.44 | $724.44 | $1,023.29 |
UPMC Health Plan Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,023.29 | Professional | None | $724.44 | $724.44 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,309.57 | Facility | None | $1,380.38 | $2,398.83 | $6,309.57 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $2,041.74 | Professional | None | $912.01 | $1,288.25 | $2,041.74 |
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 $446.68 Median $524.81 Typical High $537.03 | Professional | 52 · Reduced service | $446.68 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $208.93 Typical High $213.80 | Professional | 53 · Discontinued | $177.83 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $660.69 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $104.71 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $104.71 | $107.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $524.81 Typical High $537.03 | Professional | 52 · Reduced service | $446.68 | $524.81 | $537.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $208.93 Typical High $213.80 | Professional | 53 · Discontinued | $177.83 | $208.93 | $213.80 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $660.69 | $794.33 | $794.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $104.71 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $104.71 | $107.15 |
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· 43rd of 51
$1,072
AK $4,266TX $646
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.