How much rates vary
Facilitymedian $2,399 · 10th to 90th $933 to $7,079Professionalmedian $1,318 · 10th to 90th $1,047 to $1,585
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 $1,318.26 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,318.26 | $1,318.26 | $1,479.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $1,047.13 |
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 $1,288.25 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,348.96 | $2,041.74 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,089.30 Typical High $3,630.78 | Facility | None | $707.95 | $2,089.30 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,148.15 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,445.44 | $1,995.26 |
Geisinger Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $4,677.35 | Facility | None | $2,137.96 | $2,691.53 | $4,677.35 |
Geisinger Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,288.25 | $2,137.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $1,318.26 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,318.26 | $1,318.26 | $1,479.11 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $1,047.13 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Professional | None | $1,258.93 | $1,258.93 | $1,348.96 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,230.27 Median $2,570.40 Typical High $5,011.87 | Facility | None | $1,230.27 | $2,570.40 | $5,011.87 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,288.25 | Professional | None | $1,230.27 | $1,230.27 | $1,288.25 |
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 $1,047.13 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,380.38 | $2,041.74 |
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 $660.69 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $147.91 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $1,995.26 Typical High $2,818.38 | Professional | 50 · Both sides | $1,949.84 | $1,995.26 | $2,818.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $660.69 | $741.31 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $263.03 | $295.12 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,122.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $223.87 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $147.91 |
Where Pennsylvania sits
The same service costs 7.1 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· 41st of 51
$1,318
AK $5,370UT $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.