How much rates vary
Facilitymedian $3,631 · 10th to 90th $741 to $7,413Professionalmedian $1,479 · 10th to 90th $1,230 to $2,512
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 $891.25 Median $3,890.45 Typical High $8,317.64 | Facility | None | $891.25 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,348.96 | $1,445.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $954.99 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $851.14 | $954.99 | $1,023.29 |
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 $1,412.54 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,479.11 | $2,754.23 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,122.02 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,122.02 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $6,760.83 | Facility | None | $501.19 | $2,691.53 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,445.44 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,659.59 | $2,238.72 | $2,238.72 |
Geisinger Setting Facility Modifier None Typical Low $4,073.80 Median $5,011.87 Typical High $8,912.51 | Facility | None | $4,073.80 | $5,011.87 | $8,912.51 |
Geisinger Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,548.82 | $2,754.23 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $3,801.89 Typical High $8,317.64 | Facility | None | $954.99 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,318.26 | $1,445.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $1,023.29 |
Oscar Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,479.11 | $2,818.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,230.27 Median $1,737.80 Typical High $3,388.44 | Facility | None | $1,230.27 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,380.38 | $1,548.82 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,862.09 | $2,344.23 |
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 $616.60 Median $676.08 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $912.01 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $144.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $660.69 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $660.69 | $724.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $263.03 | $288.40 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $1,096.48 | Professional | 54 · Surgery only | $912.01 | $977.24 | $1,096.48 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $218.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $144.54 |
Where Pennsylvania sits
The same service costs 24.5 times more in Alaska than in Texas. 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· 41st of 51
$1,479
AK $5,754TX $234
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.