How much rates vary
Facilitymedian $1,862 · 10th to 90th $537 to $5,754Professionalmedian $912 · 10th to 90th $759 to $1,622
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 $758.58 Median $2,344.23 Typical High $8,317.64 | Facility | None | $758.58 | $2,344.23 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $912.01 | Professional | None | $758.58 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $616.60 | $630.96 |
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 $831.76 Median $1,348.96 Typical High $1,698.24 | Professional | None | $831.76 | $1,348.96 | $1,698.24 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,071.52 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $645.65 | $1,071.52 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $1,380.38 Typical High $2,398.83 | Facility | None | $338.84 | $1,380.38 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,548.82 | Professional | None | $758.58 | $891.25 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,202.26 | $1,202.26 | $1,288.25 |
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 $758.58 Median $1,047.13 Typical High $2,630.27 | Professional | None | $758.58 | $1,047.13 | $2,630.27 |
Martin's Point Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $7,244.36 | Facility | None | $758.58 | $2,344.23 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $912.01 | Professional | None | $758.58 | $870.96 | $912.01 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $616.60 | $630.96 |
Oscar Health Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,737.80 | Professional | None | $912.01 | $954.99 | $1,737.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $2,187.76 | Facility | None | $812.83 | $1,122.02 | $2,187.76 |
UPMC Health Plan Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | None | $831.76 | $933.25 | $933.25 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,309.57 | Facility | None | $1,380.38 | $2,398.83 | $6,309.57 |
United Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,659.59 | Professional | None | $741.31 | $954.99 | $1,659.59 |
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 $380.19 Median $436.52 Typical High $457.09 | Professional | 52 · Reduced service | $380.19 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $173.78 Typical High $181.97 | Professional | 53 · Discontinued | $151.36 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $87.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $75.86 | $87.10 | $91.20 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $2,041.74 Typical High $2,570.40 | Professional | 50 · Both sides | $1,230.27 | $2,041.74 | $2,570.40 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $436.52 Typical High $457.09 | Professional | 52 · Reduced service | $380.19 | $436.52 | $457.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $177.83 Typical High $181.97 | Professional | 53 · Discontinued | $151.36 | $177.83 | $181.97 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $660.69 | $676.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $134.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $89.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $75.86 | $89.13 | $91.20 |
Where Pennsylvania sits
The same service costs 6.9 times more in Oklahoma 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· 43rd of 51
$933
OK $3,890UT $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.