How much rates vary
Facilitymedian $214 · 10th to 90th $65 to $4,266Professionalmedian $93 · 10th to 90th $74 to $129
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 $85.11 Median $3,630.78 Typical High $8,511.38 | Facility | None | $85.11 | $3,630.78 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $117.49 | Professional | None | $74.13 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $64.57 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $52.48 | $64.57 | $74.13 |
AmeriHealth Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $144.54 | Professional | None | $93.33 | $95.50 | $144.54 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $75.86 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $74.13 | $75.86 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $457.09 | Facility | None | $50.12 | $66.07 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $128.82 | Professional | None | $70.79 | $91.20 | $128.82 |
Emblem Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $158.49 | Professional | None | $114.82 | $114.82 | $158.49 |
Geisinger Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $194.98 | Professional | None | $89.13 | $109.65 | $194.98 |
Highmark BCBS Setting Facility Modifier None Typical Low $478.63 Median $1,096.48 Typical High $1,949.84 | Facility | None | $478.63 | $1,096.48 | $1,949.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | None | $107.15 | $117.49 | $117.49 |
Independence Blue Cross Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Martin's Point Setting Facility Modifier None Typical Low $104.71 Median $3,630.78 Typical High $8,709.64 | Facility | None | $104.71 | $3,630.78 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $117.49 | Professional | None | $74.13 | $93.33 | $117.49 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $52.48 Median $64.57 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $52.48 | $64.57 | $74.13 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
UPMC Health Plan Setting Facility Modifier None Typical Low $75.86 Median $562.34 Typical High $1,479.11 | Facility | None | $75.86 | $562.34 | $1,479.11 |
UPMC Health Plan Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $138.04 | Professional | None | $75.86 | $117.49 | $138.04 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,445.44 | Facility | None | $77.62 | $158.49 | $1,445.44 |
United Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $144.54 | Professional | None | $72.44 | $93.33 | $144.54 |
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 $37.15 Median $46.77 Typical High $52.48 | Professional | 52 · Reduced service | $37.15 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.62 Typical High $20.89 | Professional | 53 · Discontinued | $14.79 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $69.18 Typical High $79.43 | Professional | 54 · Surgery only | $56.23 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.80 Typical High $15.85 | Professional | 55 · Aftercare only | $11.22 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.33 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.41 | $9.33 | $10.47 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $144.54 Typical High $208.93 | Professional | 50 · Both sides | $138.04 | $144.54 | $208.93 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $46.77 Typical High $52.48 | Professional | 52 · Reduced service | $37.15 | $46.77 | $52.48 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.62 Typical High $20.89 | Professional | 53 · Discontinued | $14.79 | $18.62 | $20.89 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $69.18 Typical High $79.43 | Professional | 54 · Surgery only | $56.23 | $69.18 | $79.43 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.80 Typical High $15.85 | Professional | 55 · Aftercare only | $11.22 | $13.80 | $15.85 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.33 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.41 | $9.33 | $10.47 |
Where Pennsylvania sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 46th of 51
$93.33
AK $324FL $77.62
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.