How much rates vary
Facilitymedian $1,585 · 10th to 90th $661 to $5,012Professionalmedian $832 · 10th to 90th $661 to $1,047
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 $912.01 Median $3,090.30 Typical High $8,511.38 | Facility | None | $912.01 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $912.01 | Professional | None | $724.44 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $645.65 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $1,318.26 | Professional | None | $831.76 | $851.14 | $1,318.26 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,202.26 Typical High $2,089.30 | Facility | None | $478.63 | $1,202.26 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,148.15 | Professional | None | $602.56 | $724.44 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None | $891.25 | $891.25 | $1,230.27 |
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 $630.96 Median $794.33 Typical High $1,258.93 | Professional | None | $630.96 | $794.33 | $1,258.93 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $8,128.31 | Facility | None | $1,698.24 | $3,162.28 | $8,128.31 |
Highmark BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,380.38 | Professional | None | $776.25 | $1,047.13 | $1,380.38 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $2,754.23 Typical High $8,317.64 | Facility | None | $912.01 | $2,754.23 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $912.01 | Professional | None | $794.33 | $812.83 | $912.01 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $645.65 |
Oscar Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $812.83 | Professional | None | $776.25 | $776.25 | $812.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $724.44 Median $1,513.56 Typical High $3,019.95 | Facility | None | $724.44 | $1,513.56 | $3,019.95 |
UPMC Health Plan Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $812.83 | Professional | None | $724.44 | $724.44 | $812.83 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,380.38 Typical High $4,265.80 | Facility | None | $812.83 | $1,380.38 | $4,265.80 |
United Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,348.96 | Professional | None | $645.65 | $870.96 | $1,348.96 |
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 $407.38 Median $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $91.20 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $91.20 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,288.25 Typical High $1,778.28 | Professional | 50 · Both sides | $1,230.27 | $1,288.25 | $1,778.28 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $407.38 | $457.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $165.96 | $181.97 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $616.60 | $691.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $138.04 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $91.20 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $91.20 |
Where Pennsylvania sits
The same service costs 3.3 times more in Oklahoma than in Maryland. 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.
Physician feeFacility fee
OK $6,981MD $2,101
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.