How much rates vary
Facilitymedian $1,698 · 10th to 90th $603 to $5,888Professionalmedian $617 · 10th to 90th $417 to $1,122
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 $660.69 Median $3,715.35 Typical High $8,317.64 | Facility | None | $660.69 | $3,715.35 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $707.95 | Professional | None | $416.87 | $575.44 | $707.95 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $56,234.13 | Facility | None | $3,981.07 | $7,413.10 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,412.54 | Professional | None | $630.96 | $977.24 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,445.44 Typical High $2,454.71 | Facility | None | $524.81 | $1,445.44 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $1,023.29 | Professional | None | $436.52 | $602.56 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | None | $1,071.52 | $1,071.52 | $1,122.02 |
Geisinger Setting Facility Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $3,162.28 | Facility | None | $1,445.44 | $1,778.28 | $3,162.28 |
Geisinger Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $1,122.02 | Professional | None | $446.68 | $691.83 | $1,122.02 |
Highmark BCBS Setting Facility Modifier None Typical Low $23,442.29 Median $23,442.29 Typical High $23,442.29 | Facility | None | $23,442.29 | $23,442.29 | $23,442.29 |
Martin's Point Setting Facility Modifier None Typical Low $707.95 Median $3,715.35 Typical High $8,317.64 | Facility | None | $707.95 | $3,715.35 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $707.95 | Professional | None | $416.87 | $575.44 | $707.95 |
Oscar Health Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,288.25 | Professional | None | $512.86 | $616.60 | $1,288.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $398.11 Median $2,454.71 Typical High $5,623.41 | Facility | None | $398.11 | $2,454.71 | $5,623.41 |
UPMC Health Plan Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $630.96 | Professional | None | $398.11 | $549.54 | $630.96 |
United Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $4,570.88 | Facility | None | $812.83 | $1,318.26 | $4,570.88 |
United Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $1,023.29 | Professional | None | $436.52 | $616.60 | $1,023.29 |
13 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 $288.40 Typical High $354.81 | Professional | 52 · Reduced service | $208.93 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $114.82 Typical High $141.25 | Professional | 53 · Discontinued | $83.18 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $309.03 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $87.10 Typical High $104.71 | Professional | 55 · Aftercare only | $61.66 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $57.54 Typical High $70.79 | Professional | 56 · Pre-op care only | $41.69 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $288.40 | $407.38 | $489.78 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,479.11 Typical High $2,089.30 | Professional | 50 · Both sides | $954.99 | $1,479.11 | $2,089.30 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $288.40 Typical High $354.81 | Professional | 52 · Reduced service | $208.93 | $288.40 | $354.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $114.82 Typical High $141.25 | Professional | 53 · Discontinued | $83.18 | $114.82 | $141.25 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $309.03 | $436.52 | $524.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $87.10 Typical High $104.71 | Professional | 55 · Aftercare only | $61.66 | $87.10 | $104.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $57.54 Typical High $70.79 | Professional | 56 · Pre-op care only | $41.69 | $57.54 | $70.79 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $288.40 | $407.38 | $489.78 |
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· 46th of 51
$661
AK $2,291KY $562
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.