How much rates vary
Facilitymedian $933 · 10th to 90th $501 to $5,012Professionalmedian $724 · 10th to 90th $603 to $1,318
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 $724.44 Median $3,890.45 Typical High $8,317.64 | Facility | None | $724.44 | $3,890.45 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $724.44 | Professional | None | $602.56 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $489.78 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $489.78 | $501.19 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $12,022.64 Typical High $56,234.13 | Facility | None | $3,981.07 | $12,022.64 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,348.96 | Professional | None | $660.69 | $1,071.52 | $1,348.96 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $851.14 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $512.86 | $851.14 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $1,348.96 | Facility | None | $501.19 | $794.33 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,230.27 | Professional | None | $602.56 | $707.95 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,023.29 | Professional | None | $954.99 | $954.99 | $1,023.29 |
Geisinger Setting Facility Modifier None Typical Low $645.65 Median $794.33 Typical High $1,412.54 | Facility | None | $645.65 | $794.33 | $1,412.54 |
Geisinger Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,380.38 | Professional | None | $602.56 | $812.83 | $1,380.38 |
Martin's Point Setting Facility Modifier None Typical Low $776.25 Median $3,801.89 Typical High $8,317.64 | Facility | None | $776.25 | $3,801.89 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $724.44 | Professional | None | $602.56 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $489.78 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $489.78 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,380.38 | Professional | None | $660.69 | $758.58 | $1,380.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $660.69 Median $1,737.80 Typical High $3,388.44 | Facility | None | $660.69 | $1,737.80 | $3,388.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | None | $660.69 | $707.95 | $707.95 |
United Setting Facility Modifier None Typical Low $416.87 Median $724.44 Typical High $3,467.37 | Facility | None | $416.87 | $724.44 | $3,467.37 |
United Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,318.26 | Professional | None | $575.44 | $776.25 | $1,318.26 |
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 $295.12 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $295.12 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $120.23 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $524.81 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $104.71 Typical High $107.15 | Professional | 55 · Aftercare only | $89.13 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $72.44 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,621.81 Typical High $1,995.26 | Professional | 50 · Both sides | $977.24 | $1,621.81 | $1,995.26 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $295.12 | $346.74 | $363.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $141.25 Typical High $144.54 | Professional | 53 · Discontinued | $120.23 | $141.25 | $144.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $524.81 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $524.81 | $537.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $104.71 Typical High $107.15 | Professional | 55 · Aftercare only | $89.13 | $104.71 | $107.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $72.44 |
Where Pennsylvania sits
The same service costs 5.9 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· 44th of 51
$724
AK $2,692UT $457
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.