How much rates vary
Facilitymedian $513 · 10th to 90th $295 to $5,623Professionalmedian $537 · 10th to 90th $468 to $759
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 $549.54 Median $5,370.32 Typical High $8,709.64 | Facility | None | $549.54 | $5,370.32 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $645.65 | Professional | None | $478.63 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $331.13 | $346.74 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $537.03 | Professional | None | $416.87 | $501.19 | $537.03 |
AmeriHealth Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
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 $501.19 Median $524.81 Typical High $1,000.00 | Professional | None | $501.19 | $524.81 | $1,000.00 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $363.08 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $354.81 | $363.08 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $426.58 Typical High $645.65 | Facility | None | $302.00 | $426.58 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $691.83 | Professional | None | $389.05 | $512.86 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $630.96 Typical High $870.96 | Professional | None | $162.18 | $630.96 | $870.96 |
Geisinger Setting Facility Modifier None Typical Low $288.40 Median $354.81 Typical High $630.96 | Facility | None | $288.40 | $354.81 | $630.96 |
Geisinger Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,071.52 | Professional | None | $512.86 | $645.65 | $1,071.52 |
Highmark BCBS Setting Facility Modifier None Typical Low $436.52 Median $776.25 Typical High $2,511.89 | Facility | None | $436.52 | $776.25 | $2,511.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $724.44 | Professional | None | $562.34 | $630.96 | $724.44 |
Independence Blue Cross Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Martin's Point Setting Facility Modifier None Typical Low $588.84 Median $4,897.79 Typical High $8,709.64 | Facility | None | $588.84 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $630.96 | Professional | None | $478.63 | $537.03 | $630.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $346.74 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $331.13 | $346.74 | $389.05 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $794.33 | Professional | None | $758.58 | $758.58 | $794.33 |
UPMC Health Plan Setting Facility Modifier None Typical Low $478.63 Median $758.58 Typical High $1,122.02 | Facility | None | $478.63 | $758.58 | $1,122.02 |
UPMC Health Plan Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $758.58 | Professional | None | $478.63 | $741.31 | $758.58 |
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 $467.74 Median $562.34 Typical High $831.76 | Professional | None | $467.74 | $562.34 | $831.76 |
12 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 $239.88 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $54.95 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $776.25 Typical High $1,479.11 | Professional | 50 · Both sides | $758.58 | $776.25 | $1,479.11 |
Highmark BCBS Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 79 · Unrelated procedure after surgery | $575.44 | $630.96 | $630.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $251.19 | $275.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $100.00 | $112.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $371.54 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $371.54 | $416.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $83.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $54.95 |
Where Pennsylvania sits
The same service costs 6.2 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· 45th of 51
$537
AK $1,995UT $324
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.