How much rates vary
Facilitymedian $933 · 10th to 90th $331 to $5,370Professionalmedian $389 · 10th to 90th $316 to $501
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 $478.63 Median $2,344.23 Typical High $8,317.64 | Facility | None | $478.63 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $478.63 | Professional | None | $323.59 | $380.19 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $263.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $229.09 | $263.03 | $338.84 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $660.69 | Professional | None | $426.58 | $436.52 | $660.69 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $309.03 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $295.12 | $309.03 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $489.78 Typical High $851.14 | Facility | None | $316.23 | $489.78 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $512.86 | Professional | None | $269.15 | $338.84 | $512.86 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Geisinger Setting Facility Modifier None Typical Low $288.40 Median $354.81 Typical High $630.96 | Facility | None | $288.40 | $354.81 | $630.96 |
Geisinger Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $741.31 | Professional | None | $295.12 | $436.52 | $741.31 |
Highmark BCBS Setting Facility Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Facility | None | $10,715.19 | $10,715.19 | $10,715.19 |
Highmark BCBS Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Martin's Point Setting Facility Modifier None Typical Low $478.63 Median $2,137.96 Typical High $7,244.36 | Facility | None | $478.63 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $478.63 | Professional | None | $323.59 | $380.19 | $478.63 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $263.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $229.09 | $263.03 | $338.84 |
Oscar Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $371.54 | Professional | None | $354.81 | $354.81 | $371.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $316.23 Median $2,398.83 Typical High $5,623.41 | Facility | None | $316.23 | $2,398.83 | $5,623.41 |
UPMC Health Plan Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $416.87 | Professional | None | $316.23 | $363.08 | $416.87 |
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 $295.12 Median $389.05 Typical High $602.56 | Professional | None | $295.12 | $389.05 | $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 $162.18 Median $190.55 Typical High $239.88 | Professional | 52 · Reduced service | $162.18 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $75.86 Typical High $95.50 | Professional | 53 · Discontinued | $64.57 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $363.08 | Professional | 54 · Surgery only | $245.47 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $72.44 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.02 Typical High $47.86 | Professional | 56 · Pre-op care only | $32.36 | $38.02 | $47.86 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $660.69 Typical High $912.01 | Professional | 50 · Both sides | $630.96 | $660.69 | $912.01 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $190.55 Typical High $239.88 | Professional | 52 · Reduced service | $162.18 | $190.55 | $239.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $75.86 Typical High $95.50 | Professional | 53 · Discontinued | $64.57 | $75.86 | $95.50 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $363.08 | Professional | 54 · Surgery only | $245.47 | $281.84 | $363.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $72.44 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $72.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.02 Typical High $47.86 | Professional | 56 · Pre-op care only | $32.36 | $38.02 | $47.86 |
Where Pennsylvania sits
The same service costs 5.0 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· 36th of 51
$417
AK $1,380UT $275
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.