How much rates vary
Facilitymedian $2,188 · 10th to 90th $776 to $6,761Professionalmedian $501 · 10th to 90th $437 to $631
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 $831.76 Median $5,495.41 Typical High $8,709.64 | Facility | None | $831.76 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $537.03 | Professional | None | $478.63 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $380.19 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $56,234.13 | Facility | None | $3,981.07 | $6,025.60 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $776.25 | Professional | None | $489.78 | $512.86 | $776.25 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $363.08 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $346.74 | $363.08 | $489.78 |
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 $380.19 Median $457.09 Typical High $691.83 | Professional | None | $380.19 | $457.09 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $707.95 | Professional | None | $512.86 | $512.86 | $707.95 |
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 $436.52 Median $512.86 Typical High $912.01 | Professional | None | $436.52 | $512.86 | $912.01 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,413.10 | $7,413.10 | $7,413.10 |
Martin's Point Setting Facility Modifier None Typical Low $912.01 Median $4,897.79 Typical High $8,709.64 | Facility | None | $912.01 | $4,897.79 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $537.03 | Professional | None | $478.63 | $489.78 | $537.03 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | None | $630.96 | $630.96 | $660.69 |
UPMC Health Plan Setting Facility Modifier None Typical Low $489.78 Median $2,187.76 Typical High $4,365.16 | Facility | None | $489.78 | $2,187.76 | $4,365.16 |
UPMC Health Plan Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $602.56 | Professional | None | $489.78 | $501.19 | $602.56 |
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 $426.58 Median $549.54 Typical High $794.33 | Professional | None | $426.58 | $549.54 | $794.33 |
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 $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $239.88 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $97.72 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | 54 · Surgery only | $363.08 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $47.86 | $48.98 | $53.70 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $776.25 Typical High $1,148.15 | Professional | 50 · Both sides | $741.31 | $776.25 | $1,148.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $239.88 | $245.47 | $269.15 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $97.72 | $97.72 | $107.15 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | 54 · Surgery only | $363.08 | $363.08 | $407.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $81.28 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $47.86 | $48.98 | $53.70 |
Where Pennsylvania sits
The same service costs 7.9 times more in Wyoming 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
$513
WY $2,399UT $302
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.