How much rates vary
Facilitymedian $1,380 · 10th to 90th $537 to $4,898Professionalmedian $447 · 10th to 90th $372 to $562
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 $501.19 Median $2,818.38 Typical High $8,511.38 | Facility | None | $501.19 | $2,818.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $501.19 | Professional | None | $389.05 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $316.23 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $275.42 | $316.23 | $354.81 |
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 $457.09 Median $467.74 Typical High $870.96 | Professional | None | $457.09 | $467.74 | $870.96 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $331.13 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $316.23 | $331.13 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,047.13 Typical High $1,862.09 | Facility | None | $478.63 | $1,047.13 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $602.56 | Professional | None | $346.74 | $389.05 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $794.33 | Professional | None | $575.44 | $575.44 | $794.33 |
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 $389.05 Median $478.63 Typical High $812.83 | Professional | None | $389.05 | $478.63 | $812.83 |
Martin's Point Setting Facility Modifier None Typical Low $575.44 Median $2,630.27 Typical High $8,317.64 | Facility | None | $575.44 | $2,630.27 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $501.19 | Professional | None | $389.05 | $446.68 | $501.19 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $316.23 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $275.42 | $316.23 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $575.44 | Professional | None | $537.03 | $537.03 | $575.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $2,511.89 | Facility | None | $446.68 | $1,096.48 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $467.74 | Professional | None | $389.05 | $446.68 | $467.74 |
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 $363.08 Median $467.74 Typical High $691.83 | Professional | None | $363.08 | $467.74 | $691.83 |
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 $194.98 Median $223.87 Typical High $251.19 | Professional | 52 · Reduced service | $194.98 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $77.62 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $295.12 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $44.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $38.90 | $44.67 | $50.12 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $707.95 Typical High $1,288.25 | Professional | 50 · Both sides | $676.08 | $707.95 | $1,288.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $223.87 Typical High $251.19 | Professional | 52 · Reduced service | $194.98 | $223.87 | $251.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $77.62 | $89.13 | $102.33 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $295.12 | $338.84 | $380.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $75.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $44.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $38.90 | $44.67 | $50.12 |
Where Pennsylvania sits
The same service costs 3.7 times more in Colorado than in North Dakota. 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
CO $4,915ND $1,319
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.