How much rates vary
Facilitymedian $316 · 10th to 90th $100 to $2,818Professionalmedian $234 · 10th to 90th $195 to $295
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 $263.03 Median $2,137.96 Typical High $8,317.64 | Facility | None | $263.03 | $2,137.96 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $263.03 | Professional | None | $208.93 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $162.18 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $144.54 | $162.18 | $186.21 |
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 $239.88 Median $251.19 Typical High $363.08 | Professional | None | $239.88 | $251.19 | $363.08 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $199.53 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $190.55 | $199.53 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $323.59 Typical High $549.54 | Facility | None | $144.54 | $323.59 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $323.59 | Professional | None | $177.83 | $204.17 | $323.59 |
Emblem Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Geisinger Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $288.40 | Facility | None | $131.83 | $165.96 | $288.40 |
Geisinger Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $436.52 | Professional | None | $208.93 | $263.03 | $436.52 |
Highmark BCBS Setting Facility Modifier None Typical Low $676.08 Median $707.95 Typical High $1,412.54 | Facility | None | $676.08 | $707.95 | $1,412.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | None | $245.47 | $245.47 | $269.15 |
Martin's Point Setting Facility Modifier None Typical Low $426.58 Median $2,137.96 Typical High $7,244.36 | Facility | None | $426.58 | $2,137.96 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $263.03 | Professional | None | $208.93 | $234.42 | $263.03 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $162.18 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $144.54 | $162.18 | $186.21 |
Oscar Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | None | $309.03 | $309.03 | $323.59 |
UPMC Health Plan Setting Facility Modifier None Typical Low $208.93 Median $269.15 Typical High $457.09 | Facility | None | $208.93 | $269.15 | $457.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $269.15 | Professional | None | $208.93 | $229.09 | $269.15 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $371.54 | Professional | None | $186.21 | $251.19 | $371.54 |
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 $104.71 Median $117.49 Typical High $131.83 | Professional | 52 · Reduced service | $104.71 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $46.77 Typical High $52.48 | Professional | 53 · Discontinued | $41.69 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $173.78 Typical High $199.53 | Professional | 54 · Surgery only | $154.88 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.44 Typical High $26.30 | Professional | 56 · Pre-op care only | $20.89 | $23.44 | $26.30 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $371.54 Typical High $512.86 | Professional | 50 · Both sides | $363.08 | $371.54 | $512.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $117.49 Typical High $131.83 | Professional | 52 · Reduced service | $104.71 | $117.49 | $131.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $46.77 Typical High $52.48 | Professional | 53 · Discontinued | $41.69 | $46.77 | $52.48 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $173.78 Typical High $199.53 | Professional | 54 · Surgery only | $154.88 | $173.78 | $199.53 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $39.81 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.44 Typical High $26.30 | Professional | 56 · Pre-op care only | $20.89 | $23.44 | $26.30 |
Where Pennsylvania sits
The same service costs 4.3 times more in Alaska than in Florida. 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· 44th of 51
$234
AK $871FL $204
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.