How much rates vary
Facilitymedian $1,349 · 10th to 90th $676 to $5,370Professionalmedian $741 · 10th to 90th $631 to $1,096
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 $741.31 Median $3,890.45 Typical High $8,511.38 | Facility | None | $741.31 | $3,890.45 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $741.31 | Professional | None | $630.96 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $512.86 |
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 $1,071.52 Median $1,148.15 Typical High $56,234.13 | Professional | None | $1,071.52 | $1,148.15 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $954.99 Typical High $1,819.70 | Facility | None | $501.19 | $954.99 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,548.82 | Professional | None | $660.69 | $741.31 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,174.90 | Professional | None | $870.96 | $1,174.90 | $1,174.90 |
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 $588.84 Median $794.33 Typical High $1,445.44 | Professional | None | $588.84 | $794.33 | $1,445.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $3,715.35 Typical High $13,489.63 | Facility | None | $1,258.93 | $3,715.35 | $13,489.63 |
Highmark BCBS Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $851.14 | Professional | None | $812.83 | $812.83 | $851.14 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $741.31 | Professional | None | $630.96 | $691.83 | $741.31 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $512.86 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,412.54 | Professional | None | $758.58 | $758.58 | $1,412.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $3,388.44 | Facility | None | $645.65 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $707.95 | Professional | None | $645.65 | $645.65 | $707.95 |
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 $691.83 Median $954.99 Typical High $1,202.26 | Professional | None | $691.83 | $954.99 | $1,202.26 |
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 $316.23 Median $346.74 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $467.74 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $104.71 Typical High $109.65 | Professional | 55 · Aftercare only | $93.33 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $74.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $331.13 | $371.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $134.90 | $147.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $467.74 | $501.19 | $549.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $109.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $67.61 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $67.61 | $74.13 |
Where Pennsylvania sits
The same service costs 3.0 times more in Alaska than in Maryland. 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
AK $5,643MD $1,856
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.