How much rates vary
Facilitymedian $4,898 · 10th to 90th $447 to $23,442Professionalmedian $316 · 10th to 90th $269 to $468
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 $537.03 Median $2,344.23 Typical High $8,317.64 | Facility | None | $537.03 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $323.59 | Professional | None | $269.15 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $208.93 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $190.55 | $208.93 | $223.87 |
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 $457.09 Median $501.19 Typical High $56,234.13 | Professional | None | $457.09 | $501.19 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $251.19 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $239.88 | $251.19 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $12,589.25 Typical High $26,302.68 | Facility | None | $346.74 | $12,589.25 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $660.69 | Professional | None | $275.42 | $316.23 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $549.54 | Professional | None | $398.11 | $549.54 | $549.54 |
Geisinger Setting Facility Modifier None Typical Low $13,182.57 Median $16,218.10 Typical High $28,840.32 | Facility | None | $13,182.57 | $16,218.10 | $28,840.32 |
Geisinger Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $933.25 | Professional | None | $302.00 | $389.05 | $933.25 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $7,244.36 | Facility | None | $588.84 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $323.59 | Professional | None | $269.15 | $288.40 | $323.59 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $204.17 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $190.55 | $204.17 | $223.87 |
Oscar Health Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $588.84 | Professional | None | $363.08 | $371.54 | $588.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $295.12 Median $1,995.26 Typical High $3,981.07 | Facility | None | $295.12 | $1,995.26 | $3,981.07 |
UPMC Health Plan Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $309.03 | Professional | None | $295.12 | $295.12 | $309.03 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $5,495.41 Typical High $33,884.42 | Facility | None | $2,818.38 | $5,495.41 | $33,884.42 |
United Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $512.86 | Professional | None | $295.12 | $407.38 | $512.86 |
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 $134.90 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $134.90 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $239.88 | Professional | 54 · Surgery only | $204.17 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $32.36 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $134.90 | $144.54 | $162.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $57.54 | $64.57 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $218.78 Typical High $239.88 | Professional | 54 · Surgery only | $204.17 | $218.78 | $239.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $43.65 | $48.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.92 | $28.84 | $32.36 |
Where Pennsylvania sits
The same service costs 29.1 times more in Alabama than in Montana. 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.
Physician feeFacility fee
AL $30,626MT $1,051
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.