How much rates vary
Facilitymedian $1,660 · 10th to 90th $813 to $6,166Professionalmedian $955 · 10th to 90th $813 to $1,202
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 $1,023.29 Median $5,495.41 Typical High $8,709.64 | Facility | None | $1,023.29 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,071.52 | Professional | None | $954.99 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $741.31 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $56,234.13 | Facility | None | $3,981.07 | $4,365.16 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,548.82 | Professional | None | $954.99 | $1,000.00 | $1,548.82 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,288.25 Typical High $2,570.40 | Facility | None | $707.95 | $1,288.25 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,318.26 | Professional | None | $758.58 | $891.25 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
Geisinger Setting Facility Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,691.53 | Facility | None | $1,230.27 | $1,513.56 | $2,691.53 |
Geisinger Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,659.59 | Professional | None | $812.83 | $954.99 | $1,659.59 |
Martin's Point Setting Facility Modifier None Typical Low $1,071.52 Median $4,897.79 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,071.52 | Professional | None | $954.99 | $954.99 | $1,071.52 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $741.31 |
Oscar Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,071.52 | Professional | None | $1,000.00 | $1,000.00 | $1,071.52 |
UPMC Health Plan Setting Facility Modifier None Typical Low $851.14 Median $2,570.40 Typical High $5,011.87 | Facility | None | $851.14 | $2,570.40 | $5,011.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | None | $851.14 | $851.14 | $954.99 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,168.69 | Facility | None | $812.83 | $1,318.26 | $4,168.69 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,548.82 | Professional | None | $812.83 | $1,047.13 | $1,548.82 |
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 $478.63 Median $478.63 Typical High $537.03 | Professional | 52 · Reduced service | $478.63 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $707.95 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $107.15 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $107.15 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,513.56 Typical High $2,089.30 | Professional | 50 · Both sides | $1,445.44 | $1,513.56 | $2,089.30 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | 52 · Reduced service | $478.63 | $478.63 | $537.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $190.55 | $213.80 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $707.95 | $724.44 | $794.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $162.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $107.15 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $107.15 |
Where Pennsylvania sits
The same service costs 7.2 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· 42nd of 51
$1,000
AK $3,981UT $550
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.