How much rates vary
Facilitymedian $447 · 10th to 90th $78 to $4,169Professionalmedian $151 · 10th to 90th $117 to $251
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 $147.91 Median $1,737.80 Typical High $7,244.36 | Facility | None | $147.91 | $1,737.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $177.83 | Professional | None | $104.71 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $93.33 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $74.13 | $93.33 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $275.42 | Professional | None | $151.36 | $239.88 | $275.42 |
AmeriHealth Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $5,623.41 | Facility | None | $1,513.56 | $3,801.89 | $5,623.41 |
AmeriHealth Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $181.97 | Professional | None | $138.04 | $162.18 | $181.97 |
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 $151.36 Median $154.88 Typical High $295.12 | Professional | None | $151.36 | $154.88 | $295.12 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $125.89 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $120.23 | $125.89 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $117.49 Typical High $660.69 | Facility | None | $70.79 | $117.49 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $251.19 | Professional | None | $117.49 | $151.36 | $251.19 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $281.84 | Professional | None | $199.53 | $281.84 | $281.84 |
Geisinger Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $162.18 | Facility | None | $74.13 | $93.33 | $162.18 |
Geisinger Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $331.13 | Professional | None | $147.91 | $190.55 | $331.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $407.38 Median $741.31 Typical High $1,445.44 | Facility | None | $407.38 | $741.31 | $1,445.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Independence Blue Cross Setting Facility Modifier None Typical Low $416.87 Median $2,630.27 Typical High $5,623.41 | Facility | None | $416.87 | $2,630.27 | $5,623.41 |
Independence Blue Cross Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $181.97 | Professional | None | $138.04 | $162.18 | $181.97 |
Martin's Point Setting Facility Modifier None Typical Low $158.49 Median $1,584.89 Typical High $6,165.95 | Facility | None | $158.49 | $1,584.89 | $6,165.95 |
Martin's Point Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $165.96 | Professional | None | $104.71 | $131.83 | $165.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $93.33 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $74.13 | $93.33 | $112.20 |
Oscar Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $234.42 | Professional | None | $154.88 | $154.88 | $234.42 |
UPMC Health Plan Setting Facility Modifier None Typical Low $120.23 Median $426.58 Typical High $831.76 | Facility | None | $120.23 | $426.58 | $831.76 |
UPMC Health Plan Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $151.36 | Professional | None | $120.23 | $131.83 | $151.36 |
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 $125.89 Median $173.78 Typical High $245.47 | Professional | None | $125.89 | $173.78 | $245.47 |
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 $52.48 Median $66.07 Typical High $79.43 | Professional | 52 · Reduced service | $52.48 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.30 Typical High $31.62 | Professional | 53 · Discontinued | $20.89 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $100.00 Typical High $120.23 | Professional | 54 · Surgery only | $79.43 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.95 Typical High $23.99 | Professional | 55 · Aftercare only | $15.85 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.18 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.47 | $13.18 | $15.85 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $66.07 Typical High $79.43 | Professional | 52 · Reduced service | $52.48 | $66.07 | $79.43 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.30 Typical High $31.62 | Professional | 53 · Discontinued | $20.89 | $26.30 | $31.62 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $100.00 Typical High $120.23 | Professional | 54 · Surgery only | $79.43 | $100.00 | $120.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.95 Typical High $23.99 | Professional | 55 · Aftercare only | $15.85 | $19.95 | $23.99 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.18 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.47 | $13.18 | $15.85 |
Where Pennsylvania sits
The same service costs 3.9 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· 40th of 51
$151
AK $501FL $129
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.