How much rates vary
Facilitymedian $1,259 · 10th to 90th $457 to $5,248Professionalmedian $427 · 10th to 90th $275 to $525
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 $316.23 Median $3,630.78 Typical High $8,511.38 | Facility | None | $316.23 | $3,630.78 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $501.19 | Professional | None | $281.84 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $275.42 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $194.98 | $275.42 | $354.81 |
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 $436.52 Median $446.68 Typical High $707.95 | Professional | None | $436.52 | $446.68 | $707.95 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $316.23 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $302.00 | $316.23 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,174.90 Typical High $2,238.72 | Facility | None | $691.83 | $1,174.90 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $524.81 | Professional | None | $245.47 | $363.08 | $524.81 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $776.25 | Professional | None | $562.34 | $562.34 | $776.25 |
Geisinger Setting Facility Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,290.87 | Facility | None | $1,047.13 | $1,318.26 | $2,290.87 |
Geisinger Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $758.58 | Professional | None | $281.84 | $478.63 | $758.58 |
Martin's Point Setting Facility Modifier None Typical Low $501.19 Median $3,630.78 Typical High $8,709.64 | Facility | None | $501.19 | $3,630.78 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $501.19 | Professional | None | $281.84 | $436.52 | $501.19 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $275.42 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $194.98 | $275.42 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $363.08 | Professional | None | $338.84 | $338.84 | $363.08 |
UPMC Health Plan Setting Facility Modifier None Typical Low $213.80 Median $338.84 Typical High $457.09 | Facility | None | $213.80 | $338.84 | $457.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $436.52 | Professional | None | $213.80 | $338.84 | $436.52 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,265.80 | Facility | None | $812.83 | $1,318.26 | $4,265.80 |
United Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $588.84 | Professional | None | $269.15 | $398.11 | $588.84 |
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 $141.25 Median $199.53 Typical High $251.19 | Professional | 52 · Reduced service | $141.25 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $79.43 Typical High $100.00 | Professional | 53 · Discontinued | $56.23 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $295.12 Typical High $380.19 | Professional | 54 · Surgery only | $208.93 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $58.88 Typical High $75.86 | Professional | 55 · Aftercare only | $41.69 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $39.81 Typical High $50.12 | Professional | 56 · Pre-op care only | $28.18 | $39.81 | $50.12 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $676.08 Typical High $954.99 | Professional | 50 · Both sides | $645.65 | $676.08 | $954.99 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $199.53 Typical High $251.19 | Professional | 52 · Reduced service | $141.25 | $199.53 | $251.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $79.43 Typical High $100.00 | Professional | 53 · Discontinued | $56.23 | $79.43 | $100.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $295.12 Typical High $380.19 | Professional | 54 · Surgery only | $208.93 | $295.12 | $380.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $58.88 Typical High $75.86 | Professional | 55 · Aftercare only | $41.69 | $58.88 | $75.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $39.81 Typical High $50.12 | Professional | 56 · Pre-op care only | $28.18 | $39.81 | $50.12 |
Where Pennsylvania sits
The same service costs 5.5 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· 35th of 51
$437
AK $1,585UT $288
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.