How much rates vary
Facilitymedian $1,479 · 10th to 90th $646 to $6,026Professionalmedian $525 · 10th to 90th $417 to $646
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 $602.56 Median $4,786.30 Typical High $8,511.38 | Facility | None | $602.56 | $4,786.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $602.56 | Professional | None | $416.87 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $363.08 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $295.12 | $363.08 | $426.58 |
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 $537.03 Median $549.54 Typical High $831.76 | Professional | None | $537.03 | $549.54 | $831.76 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $389.05 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $371.54 | $389.05 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,096.48 Typical High $2,089.30 | Facility | None | $616.60 | $1,096.48 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $691.83 | Professional | None | $371.54 | $457.09 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $933.25 | Professional | None | $676.08 | $676.08 | $933.25 |
Geisinger Setting Facility Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,290.87 | Facility | None | $1,047.13 | $1,318.26 | $2,290.87 |
Geisinger Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $933.25 | Professional | None | $436.52 | $575.44 | $933.25 |
Highmark BCBS Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Martin's Point Setting Facility Modifier None Typical Low $602.56 Median $4,570.88 Typical High $8,511.38 | Facility | None | $602.56 | $4,570.88 | $8,511.38 |
Martin's Point Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $602.56 | Professional | None | $416.87 | $524.81 | $602.56 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $363.08 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $295.12 | $363.08 | $426.58 |
Oscar Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | None | $645.65 | $645.65 | $676.08 |
UPMC Health Plan Setting Facility Modifier None Typical Low $446.68 Median $1,548.82 Typical High $3,548.13 | Facility | None | $446.68 | $1,548.82 | $3,548.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $562.34 | Professional | None | $416.87 | $524.81 | $562.34 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,265.80 | Facility | None | $812.83 | $1,318.26 | $4,265.80 |
United Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $794.33 | Professional | None | $398.11 | $512.86 | $794.33 |
12 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 $208.93 Median $263.03 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $389.05 Typical High $457.09 | Professional | 54 · Surgery only | $316.23 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $63.10 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $52.48 | $60.26 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $831.76 Typical High $1,258.93 | Professional | 50 · Both sides | $794.33 | $831.76 | $1,258.93 |
Highmark BCBS Setting Facility Modifier 59 · Distinct service Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | 59 · Distinct service | $1,348.96 | $1,348.96 | $1,348.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $263.03 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $263.03 | $302.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $104.71 | $120.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $389.05 Typical High $457.09 | Professional | 54 · Surgery only | $316.23 | $389.05 | $457.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $63.10 | $77.62 | $91.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $52.48 | $60.26 |
Where Pennsylvania sits
The same service costs 6.5 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· 39th of 51
$537
AK $2,239UT $347
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.