How much rates vary
Facilitymedian $3,631 · 10th to 90th $741 to $7,413Professionalmedian $1,413 · 10th to 90th $1,202 to $2,455
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 $3,801.89 Typical High $8,317.64 | Facility | None | $891.25 | $3,801.89 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,288.25 | $1,380.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $977.24 |
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 $1,380.38 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,412.54 | $2,630.27 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,995.26 |
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 $1,288.25 Median $1,412.54 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,412.54 | $2,884.03 |
Emblem Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,584.89 | $2,137.96 | $2,137.96 |
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 $1,230.27 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,621.81 | $2,884.03 |
Martin's Point Setting Facility Modifier None Typical Low $954.99 Median $3,715.35 Typical High $8,317.64 | Facility | None | $954.99 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,258.93 | $1,380.38 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $977.24 |
Oscar Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,548.82 | $1,548.82 | $2,691.53 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $3,467.37 | Facility | None | $1,258.93 | $1,737.80 | $3,467.37 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,348.96 | $1,412.54 | $1,412.54 |
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 $1,288.25 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,778.28 | $2,238.72 |
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 $588.84 Median $645.65 Typical High $691.83 | Professional | 52 · Reduced service | $588.84 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $275.42 | Professional | 53 · Discontinued | $234.42 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $1,047.13 | Professional | 54 · Surgery only | $891.25 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $208.93 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $138.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $588.84 | $630.96 | $691.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $275.42 | Professional | 53 · Discontinued | $234.42 | $251.19 | $275.42 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $1,047.13 | Professional | 54 · Surgery only | $891.25 | $954.99 | $1,047.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $208.93 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $138.04 |
Where Pennsylvania sits
The same service costs 7.2 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· 40th of 51
$1,413
AK $5,495TX $759
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.