How much rates vary
Facilitymedian $525 · 10th to 90th $302 to $2,818Professionalmedian $537 · 10th to 90th $468 to $933
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 $537.03 Median $2,344.23 Typical High $8,317.64 | Facility | None | $537.03 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $616.60 | Professional | None | $478.63 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $398.11 |
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 $512.86 Median $537.03 Typical High $851.14 | Professional | None | $512.86 | $537.03 | $851.14 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $371.54 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $363.08 | $371.54 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $426.58 Typical High $645.65 | Facility | None | $309.03 | $426.58 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $891.25 | Professional | None | $398.11 | $512.86 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
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 $549.54 Median $912.01 Typical High $1,288.25 | Professional | None | $549.54 | $912.01 | $1,288.25 |
Highmark BCBS Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $645.65 | Professional | None | $602.56 | $645.65 | $645.65 |
Martin's Point Setting Facility Modifier None Typical Low $575.44 Median $2,137.96 Typical High $7,244.36 | Facility | None | $575.44 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $575.44 | Professional | None | $478.63 | $524.81 | $575.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,174.90 | Professional | None | $1,096.48 | $1,096.48 | $1,174.90 |
UPMC Health Plan Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $1,905.46 | Facility | None | $512.86 | $933.25 | $1,905.46 |
UPMC Health Plan Setting Professional Modifier None Typical Low $478.63 Median $891.25 Typical High $933.25 | Professional | None | $478.63 | $891.25 | $933.25 |
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 $575.44 Typical High $1,023.29 | Professional | None | $467.74 | $575.44 | $1,023.29 |
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 $239.88 Median $257.04 Typical High $288.40 | Professional | 52 · Reduced service | $239.88 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $114.82 | Professional | 53 · Discontinued | $95.50 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $354.81 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $57.54 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $57.54 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $794.33 Typical High $1,258.93 | Professional | 50 · Both sides | $776.25 | $794.33 | $1,258.93 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $257.04 Typical High $288.40 | Professional | 52 · Reduced service | $239.88 | $257.04 | $288.40 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $114.82 | Professional | 53 · Discontinued | $95.50 | $102.33 | $114.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $354.81 | $389.05 | $426.58 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $85.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $57.54 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $57.54 |
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.