How much rates vary
Facilitymedian $2,188 · 10th to 90th $933 to $7,079Professionalmedian $1,349 · 10th to 90th $1,072 to $1,622
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 $1,047.13 Median $5,495.41 Typical High $8,709.64 | Facility | None | $1,047.13 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,348.96 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,071.52 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,380.38 | $2,089.30 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $3,235.94 | Facility | None | $707.95 | $1,737.80 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,174.90 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,479.11 | $2,041.74 |
Geisinger Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $3,715.35 | Facility | None | $1,698.24 | $2,089.30 | $3,715.35 |
Geisinger Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,318.26 | $2,187.76 |
Martin's Point Setting Facility Modifier None Typical Low $1,148.15 Median $4,897.79 Typical High $8,709.64 | Facility | None | $1,148.15 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,348.96 | $1,348.96 | $1,513.56 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,071.52 |
Oscar Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,479.11 | Professional | None | $1,380.38 | $1,380.38 | $1,479.11 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,148.15 Median $2,570.40 Typical High $5,011.87 | Facility | None | $1,148.15 | $2,570.40 | $5,011.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,148.15 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $6,025.60 | Facility | None | $1,148.15 | $1,905.46 | $6,025.60 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,412.54 | $2,089.30 |
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 $676.08 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $676.08 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $151.36 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,089.30 Typical High $2,884.03 | Professional | 50 · Both sides | $1,995.26 | $2,089.30 | $2,884.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $676.08 | $676.08 | $758.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $275.42 | $302.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,148.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $229.09 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $151.36 |
Where Pennsylvania sits
The same service costs 7.4 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· 40th of 51
$1,349
AK $5,623UT $759
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.