How much rates vary
Facilitymedian $457 · 10th to 90th $200 to $5,754Professionalmedian $302 · 10th to 90th $263 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 $316.23 Median $5,248.07 Typical High $8,709.64 | Facility | None | $316.23 | $5,248.07 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $645.65 | Professional | None | $263.03 | $295.12 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $229.09 |
AmeriHealth Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $8,709.64 | Facility | None | $2,454.71 | $2,570.40 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $467.74 | Professional | None | $288.40 | $302.00 | $467.74 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $239.88 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $229.09 | $239.88 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $323.59 Typical High $562.34 | Facility | None | $194.98 | $323.59 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $524.81 Typical High $741.31 | Professional | None | $223.87 | $524.81 | $741.31 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $660.69 | Professional | None | $204.17 | $363.08 | $660.69 |
Geisinger Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $380.19 | Facility | None | $173.78 | $218.78 | $380.19 |
Geisinger Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $954.99 | Professional | None | $309.03 | $562.34 | $954.99 |
Highmark BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,258.93 Typical High $2,089.30 | Facility | None | $794.33 | $1,258.93 | $2,089.30 |
Highmark BCBS Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $363.08 | Professional | None | $309.03 | $363.08 | $363.08 |
Independence Blue Cross Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Martin's Point Setting Facility Modifier None Typical Low $537.03 Median $4,897.79 Typical High $8,709.64 | Facility | None | $537.03 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $616.60 | Professional | None | $263.03 | $295.12 | $616.60 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $223.87 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | None | $707.95 | $707.95 | $831.76 |
UPMC Health Plan Setting Facility Modifier None Typical Low $281.84 Median $1,819.70 Typical High $4,265.80 | Facility | None | $281.84 | $1,819.70 | $4,265.80 |
UPMC Health Plan Setting Professional Modifier None Typical Low $263.03 Median $616.60 Typical High $676.08 | Professional | None | $263.03 | $616.60 | $676.08 |
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 $257.04 Median $323.59 Typical High $630.96 | Professional | None | $257.04 | $323.59 | $630.96 |
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 $131.83 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $131.83 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $66.07 | Professional | 53 · Discontinued | $52.48 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $194.98 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $32.36 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $446.68 Typical High $691.83 | Professional | 50 · Both sides | $436.52 | $446.68 | $691.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $144.54 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $144.54 | $158.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $52.48 | $57.54 | $64.57 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $239.88 | Professional | 54 · Surgery only | $194.98 | $213.80 | $239.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $47.86 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $47.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $31.62 |
Where Pennsylvania sits
The same service costs 5.0 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· 47th of 51
$309
AK $1,096UT $219
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.