How much rates vary
Facilitymedian $1,514 · 10th to 90th $501 to $4,898Professionalmedian $537 · 10th to 90th $447 to $676
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 $602.56 Median $2,344.23 Typical High $8,317.64 | Facility | None | $602.56 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | None | $537.03 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $380.19 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $380.19 | $426.58 |
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 $537.03 Median $562.34 Typical High $831.76 | Professional | None | $537.03 | $562.34 | $831.76 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $389.05 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $380.19 | $389.05 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,174.90 Typical High $1,995.26 | Facility | None | $338.84 | $1,174.90 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $724.44 | Professional | None | $426.58 | $467.74 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $831.76 | Professional | None | $602.56 | $602.56 | $831.76 |
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 $436.52 Median $524.81 Typical High $831.76 | Professional | None | $436.52 | $524.81 | $831.76 |
Martin's Point Setting Facility Modifier None Typical Low $602.56 Median $2,344.23 Typical High $7,244.36 | Facility | None | $602.56 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | None | $537.03 | $537.03 | $602.56 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $380.19 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $380.19 | $426.58 |
Oscar Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $537.03 | Professional | None | $501.19 | $501.19 | $537.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $446.68 Median $1,122.02 Typical High $2,238.72 | Facility | None | $446.68 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $537.03 | Professional | None | $446.68 | $446.68 | $537.03 |
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 $436.52 Median $588.84 Typical High $851.14 | Professional | None | $436.52 | $588.84 | $851.14 |
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 $269.15 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $107.15 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $407.38 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $60.26 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $851.14 Typical High $1,174.90 | Professional | 50 · Both sides | $812.83 | $851.14 | $1,174.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $269.15 | $269.15 | $302.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $107.15 | $107.15 | $120.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $407.38 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $407.38 | $457.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $79.43 | $81.28 | $91.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $60.26 |
Where Pennsylvania sits
The same service costs 8.3 times more in Wyoming than in Texas. 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· 41st of 51
$562
WY $2,512TX $302
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.