How much rates vary
Facilitymedian $933 · 10th to 90th $263 to $5,012Professionalmedian $355 · 10th to 90th $224 to $437
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 $407.38 Median $3,090.30 Typical High $8,511.38 | Facility | None | $407.38 | $3,090.30 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $407.38 | Professional | None | $229.09 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $223.87 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $158.49 | $223.87 | $288.40 |
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 $354.81 Median $371.54 Typical High $562.34 | Professional | None | $354.81 | $371.54 | $562.34 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $295.12 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $288.40 | $295.12 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $645.65 Typical High $1,288.25 | Facility | None | $263.03 | $645.65 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $436.52 | Professional | None | $204.17 | $295.12 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | None | $457.09 | $457.09 | $630.96 |
Geisinger Setting Facility Modifier None Typical Low $239.88 Median $295.12 Typical High $524.81 | Facility | None | $239.88 | $295.12 | $524.81 |
Geisinger Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $616.60 | Professional | None | $239.88 | $389.05 | $616.60 |
Highmark BCBS Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Martin's Point Setting Facility Modifier None Typical Low $575.44 Median $2,691.53 Typical High $8,317.64 | Facility | None | $575.44 | $2,691.53 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $407.38 | Professional | None | $229.09 | $346.74 | $407.38 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $223.87 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $158.49 | $223.87 | $288.40 |
Oscar Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $537.03 | Professional | None | $501.19 | $501.19 | $537.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $251.19 Median $575.44 Typical High $954.99 | Facility | None | $251.19 | $575.44 | $954.99 |
UPMC Health Plan Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $575.44 | Professional | None | $229.09 | $354.81 | $575.44 |
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 $223.87 Median $331.13 Typical High $489.78 | Professional | None | $223.87 | $331.13 | $489.78 |
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 $112.20 Median $158.49 Typical High $204.17 | Professional | 52 · Reduced service | $112.20 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $64.57 Typical High $81.28 | Professional | 53 · Discontinued | $45.71 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $309.03 | Professional | 54 · Surgery only | $169.82 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $47.86 Typical High $61.66 | Professional | 55 · Aftercare only | $33.88 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $31.62 Typical High $40.74 | Professional | 56 · Pre-op care only | $22.91 | $31.62 | $40.74 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $562.34 Typical High $776.25 | Professional | 50 · Both sides | $537.03 | $562.34 | $776.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $158.49 Typical High $204.17 | Professional | 52 · Reduced service | $112.20 | $158.49 | $204.17 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $64.57 Typical High $81.28 | Professional | 53 · Discontinued | $45.71 | $64.57 | $81.28 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $309.03 | Professional | 54 · Surgery only | $169.82 | $239.88 | $309.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $47.86 Typical High $61.66 | Professional | 55 · Aftercare only | $33.88 | $47.86 | $61.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $31.62 Typical High $40.74 | Professional | 56 · Pre-op care only | $22.91 | $31.62 | $40.74 |
Where Pennsylvania sits
The same service costs 3.9 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· 38th of 51
$355
WY $1,096UT $282
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.