How much rates vary
Facilitymedian $537 · 10th to 90th $302 to $3,802Professionalmedian $380 · 10th to 90th $309 to $468
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 $426.58 Median $2,951.21 Typical High $8,511.38 | Facility | None | $426.58 | $2,951.21 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $426.58 | Professional | None | $338.84 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $263.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $239.88 | $263.03 | $295.12 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $56,234.13 | Facility | None | $2,511.89 | $2,570.40 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $588.84 | Professional | None | $380.19 | $389.05 | $588.84 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $275.42 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $263.03 | $275.42 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $478.63 Typical High $831.76 | Facility | None | $323.59 | $478.63 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $501.19 | Professional | None | $288.40 | $338.84 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $660.69 | Professional | None | $478.63 | $478.63 | $660.69 |
Geisinger Setting Facility Modifier None Typical Low $295.12 Median $363.08 Typical High $645.65 | Facility | None | $295.12 | $363.08 | $645.65 |
Geisinger Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $660.69 | Professional | None | $302.00 | $398.11 | $660.69 |
Highmark BCBS Setting Facility Modifier None Typical Low $288.40 Median $457.09 Typical High $512.86 | Facility | None | $288.40 | $457.09 | $512.86 |
Highmark BCBS Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $467.74 | Professional | None | $398.11 | $436.52 | $467.74 |
Martin's Point Setting Facility Modifier None Typical Low $575.44 Median $2,691.53 Typical High $8,317.64 | Facility | None | $575.44 | $2,691.53 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $426.58 | Professional | None | $338.84 | $380.19 | $426.58 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $263.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $239.88 | $263.03 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $371.54 | Professional | None | $346.74 | $346.74 | $371.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $371.54 Median $1,071.52 Typical High $2,511.89 | Facility | None | $371.54 | $1,071.52 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $416.87 | Professional | None | $338.84 | $380.19 | $416.87 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $1,862.09 | Facility | None | $199.53 | $436.52 | $1,862.09 |
United Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $588.84 | Professional | None | $295.12 | $407.38 | $588.84 |
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 $169.82 Median $190.55 Typical High $208.93 | Professional | 52 · Reduced service | $169.82 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $85.11 | Professional | 53 · Discontinued | $67.61 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $257.04 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $51.29 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $42.66 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $588.84 Typical High $812.83 | Professional | 50 · Both sides | $562.34 | $588.84 | $812.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $190.55 Typical High $208.93 | Professional | 52 · Reduced service | $169.82 | $190.55 | $208.93 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $85.11 | Professional | 53 · Discontinued | $67.61 | $75.86 | $85.11 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $257.04 | $281.84 | $316.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $51.29 | $56.23 | $63.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $42.66 |
Where Pennsylvania sits
The same service costs 5.6 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· 41st of 51
$380
AK $1,413UT $251
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.