How much rates vary
Facilitymedian $427 · 10th to 90th $87 to $4,074Professionalmedian $138 · 10th to 90th $112 to $234
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 $138.04 Median $1,995.26 Typical High $7,943.28 | Facility | None | $138.04 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $169.82 | Professional | None | $100.00 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $83.18 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $70.79 | $83.18 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | None | $125.89 | $125.89 | $134.90 |
AmeriHealth Setting Facility Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $7,585.78 | Facility | None | $2,290.87 | $3,162.28 | $7,585.78 |
AmeriHealth Setting Professional Modifier None Typical Low $50.12 Median $141.25 Typical High $257.04 | Professional | None | $50.12 | $141.25 | $257.04 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $269.15 | Professional | None | $134.90 | $141.25 | $269.15 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $112.20 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $107.15 | $112.20 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $245.47 Typical High $549.54 | Facility | None | $93.33 | $245.47 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $239.88 | Professional | None | $114.82 | $134.90 | $239.88 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $245.47 | Professional | None | $181.97 | $245.47 | $245.47 |
Geisinger Setting Facility Modifier None Typical Low $85.11 Median $104.71 Typical High $186.21 | Facility | None | $85.11 | $104.71 | $186.21 |
Geisinger Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $338.84 | Professional | None | $134.90 | $186.21 | $338.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $426.58 Median $1,000.00 Typical High $1,737.80 | Facility | None | $426.58 | $1,000.00 | $1,737.80 |
Highmark BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Independence Blue Cross Setting Facility Modifier None Typical Low $436.52 Median $3,090.30 Typical High $5,623.41 | Facility | None | $436.52 | $3,090.30 | $5,623.41 |
Independence Blue Cross Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $257.04 | Professional | None | $70.79 | $83.18 | $257.04 |
Martin's Point Setting Facility Modifier None Typical Low $138.04 Median $1,819.70 Typical High $6,606.93 | Facility | None | $138.04 | $1,819.70 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $169.82 | Professional | None | $100.00 | $120.23 | $169.82 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $83.18 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $70.79 | $83.18 | $97.72 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $309.03 | Professional | None | $162.18 | $208.93 | $309.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $131.83 Median $363.08 Typical High $831.76 | Facility | None | $131.83 | $363.08 | $831.76 |
UPMC Health Plan Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $181.97 | Professional | None | $114.82 | $144.54 | $181.97 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $223.87 | Professional | None | $117.49 | $154.88 | $223.87 |
11 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 $50.12 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $50.12 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $23.99 Typical High $27.54 | Professional | 53 · Discontinued | $19.95 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $89.13 Typical High $104.71 | Professional | 54 · Surgery only | $75.86 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $15.14 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.02 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.00 | $12.02 | $13.80 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $204.17 Median $208.93 Typical High $407.38 | Professional | 50 · Both sides | $204.17 | $208.93 | $407.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $50.12 | $60.26 | $69.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $23.99 Typical High $27.54 | Professional | 53 · Discontinued | $19.95 | $23.99 | $27.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $89.13 Typical High $104.71 | Professional | 54 · Surgery only | $75.86 | $89.13 | $104.71 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $15.14 | $17.78 | $20.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.02 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.00 | $12.02 | $13.80 |
Where Pennsylvania sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 44th of 51
$138
AK $490FL $117
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.