How much rates vary
Facilitymedian $794 · 10th to 90th $316 to $6,166Professionalmedian $372 · 10th to 90th $324 to $468
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 $588.84 Median $3,235.94 Typical High $8,511.38 | Facility | None | $588.84 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $407.38 | Professional | None | $363.08 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $288.40 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $28,183.83 Typical High $56,234.13 | Facility | None | $3,981.07 | $28,183.83 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $371.54 Median $380.19 Typical High $588.84 | Professional | None | $371.54 | $380.19 | $588.84 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $269.15 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $257.04 | $269.15 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $660.69 Typical High $2,290.87 | Facility | None | $380.19 | $660.69 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $512.86 | Professional | None | $288.40 | $338.84 | $512.86 |
Emblem Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $537.03 | Professional | None | $389.05 | $389.05 | $537.03 |
Geisinger Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $616.60 | Professional | None | $309.03 | $363.08 | $616.60 |
Martin's Point Setting Facility Modifier None Typical Low $724.44 Median $2,818.38 Typical High $8,317.64 | Facility | None | $724.44 | $2,818.38 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $407.38 | Professional | None | $363.08 | $371.54 | $407.38 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $288.40 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | None | $389.05 | $389.05 | $407.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $363.08 | Facility | None | $346.74 | $346.74 | $363.08 |
UPMC Health Plan Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | None | $346.74 | $346.74 | $363.08 |
United Setting Facility Modifier None Typical Low $199.53 Median $562.34 Typical High $4,265.80 | Facility | None | $199.53 | $562.34 | $4,265.80 |
United Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $602.56 | Professional | None | $316.23 | $407.38 | $602.56 |
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 $181.97 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $181.97 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $72.44 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $275.42 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $36.31 | $37.15 | $40.74 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $575.44 Typical High $794.33 | Professional | 50 · Both sides | $549.54 | $575.44 | $794.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $181.97 | $186.21 | $204.17 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $72.44 | $74.13 | $81.28 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $275.42 | $275.42 | $309.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $61.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $36.31 | $37.15 | $40.74 |
Where Pennsylvania sits
The same service costs 6.9 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· 40th of 51
$380
AK $1,514UT $219
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.