How much rates vary
Facilitymedian $355 · 10th to 90th $129 to $3,388Professionalmedian $178 · 10th to 90th $110 to $316
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 $158.49 Median $1,819.70 Typical High $7,244.36 | Facility | None | $158.49 | $1,819.70 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $234.42 | Professional | None | $109.65 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $112.20 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $77.62 | $112.20 | $141.25 |
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 $177.83 Median $295.12 Typical High $354.81 | Professional | None | $177.83 | $295.12 | $354.81 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $239.88 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $144.54 | $239.88 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $147.91 Typical High $275.42 | Facility | None | $50.12 | $147.91 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $302.00 | Professional | None | $107.15 | $177.83 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $8.13 Median $147.91 Typical High $316.23 | Professional | None | $8.13 | $147.91 | $316.23 |
Geisinger Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $288.40 | Facility | None | $131.83 | $165.96 | $288.40 |
Geisinger Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $323.59 | Professional | None | $117.49 | $204.17 | $323.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $3,019.95 | Facility | None | $691.83 | $1,348.96 | $3,019.95 |
Martin's Point Setting Facility Modifier None Typical Low $158.49 Median $1,584.89 Typical High $6,165.95 | Facility | None | $158.49 | $1,584.89 | $6,165.95 |
Martin's Point Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $234.42 | Professional | None | $109.65 | $165.96 | $234.42 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $112.20 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $77.62 | $112.20 | $141.25 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $354.81 | Professional | None | $141.25 | $151.36 | $354.81 |
UPMC Health Plan Setting Facility Modifier None Typical Low $114.82 Median $302.00 Typical High $691.83 | Facility | None | $114.82 | $302.00 | $691.83 |
UPMC Health Plan Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $186.21 | Professional | None | $114.82 | $177.83 | $186.21 |
United Setting Facility Modifier None Typical Low $199.53 Median $436.52 Typical High $2,089.30 | Facility | None | $199.53 | $436.52 | $2,089.30 |
United Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $295.12 | Professional | None | $114.82 | $177.83 | $295.12 |
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 $54.95 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $54.95 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $40.74 | Professional | 53 · Discontinued | $21.88 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $83.18 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $16.60 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.96 | $16.22 | $20.42 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $446.68 Typical High $537.03 | Professional | 50 · Both sides | $269.15 | $446.68 | $537.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $54.95 | $81.28 | $102.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $40.74 | Professional | 53 · Discontinued | $21.88 | $32.36 | $40.74 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $83.18 | $120.23 | $151.36 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $16.60 | $24.55 | $30.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.96 | $16.22 | $20.42 |
Where Pennsylvania sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 40th of 51
$186
AK $513KY $126
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.