How much rates vary
Facilitymedian $1,549 · 10th to 90th $646 to $5,495Professionalmedian $661 · 10th to 90th $550 to $1,122
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 $660.69 Median $4,897.79 Typical High $8,511.38 | Facility | None | $660.69 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $660.69 | Professional | None | $549.54 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $457.09 |
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 $645.65 Median $660.69 Typical High $1,174.90 | Professional | None | $645.65 | $660.69 | $1,174.90 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,174.90 Typical High $2,290.87 | Facility | None | $549.54 | $1,174.90 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $1,318.26 | Professional | None | $549.54 | $630.96 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,096.48 | Professional | None | $794.33 | $1,096.48 | $1,096.48 |
Geisinger Setting Facility Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,570.40 | Facility | None | $1,174.90 | $1,445.44 | $2,570.40 |
Geisinger Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,318.26 | Professional | None | $588.84 | $776.25 | $1,318.26 |
Martin's Point Setting Facility Modifier None Typical Low $660.69 Median $3,801.89 Typical High $8,709.64 | Facility | None | $660.69 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $660.69 | Professional | None | $549.54 | $588.84 | $660.69 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $457.09 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,230.27 | Professional | None | $707.95 | $707.95 | $1,230.27 |
UPMC Health Plan Setting Facility Modifier None Typical Low $616.60 Median $645.65 Typical High $645.65 | Facility | None | $616.60 | $645.65 | $645.65 |
UPMC Health Plan Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | None | $616.60 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $4,365.16 | Facility | None | $1,148.15 | $1,905.46 | $4,365.16 |
United Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,047.13 | Professional | None | $602.56 | $812.83 | $1,047.13 |
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 $275.42 Median $295.12 Typical High $323.59 | Professional | 52 · Reduced service | $275.42 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $66.07 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,000.00 Typical High $1,778.28 | Professional | 50 · Both sides | $954.99 | $1,000.00 | $1,778.28 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $295.12 Typical High $323.59 | Professional | 52 · Reduced service | $275.42 | $295.12 | $323.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $117.49 | $131.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $446.68 | $489.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $97.72 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $66.07 |
Where Pennsylvania sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$661
AK $2,570UT $447
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.