How much rates vary
Facilitymedian $1,349 · 10th to 90th $813 to $5,012Professionalmedian $1,072 · 10th to 90th $871 to $1,778
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 $954.99 Median $3,090.30 Typical High $8,511.38 | Facility | None | $954.99 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,122.02 | Professional | None | $933.25 | $1,000.00 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $794.33 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,981.07 | $6,025.60 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,778.28 | $1,949.84 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $870.96 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $851.14 | $870.96 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,071.52 Typical High $2,089.30 | Facility | None | $501.19 | $1,071.52 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $2,290.87 | Professional | None | $741.31 | $1,000.00 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,995.26 | $1,995.26 |
Geisinger Setting Facility Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,041.74 | Facility | None | $912.01 | $1,148.15 | $2,041.74 |
Geisinger Setting Professional Modifier None Typical Low $794.33 Median $1,318.26 Typical High $1,862.09 | Professional | None | $794.33 | $1,318.26 | $1,862.09 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $8,317.64 | Facility | None | $954.99 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,122.02 | Professional | None | $933.25 | $1,000.00 | $1,122.02 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,000.00 | $1,621.81 |
UPMC Health Plan Setting Facility Modifier None Typical Low $977.24 Median $1,513.56 Typical High $2,951.21 | Facility | None | $977.24 | $1,513.56 | $2,951.21 |
UPMC Health Plan Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,071.52 | Professional | None | $977.24 | $977.24 | $1,071.52 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $3,981.07 | Facility | None | $812.83 | $1,318.26 | $3,981.07 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,778.28 | Professional | None | $912.01 | $1,258.93 | $1,778.28 |
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 $467.74 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $467.74 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $707.95 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $112.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $467.74 | $501.19 | $562.34 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $199.53 | $223.87 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $707.95 | $758.58 | $851.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $169.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $112.20 |
Where Pennsylvania sits
The same service costs 5.9 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· 42nd of 51
$1,096
AK $4,467TX $759
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.