How much rates vary
Facilitymedian $2,884 · 10th to 90th $692 to $8,318Professionalmedian $1,995 · 10th to 90th $1,660 to $3,631
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 $1,047.13 Median $5,495.41 Typical High $8,709.64 | Facility | None | $1,047.13 | $5,495.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,905.46 | $1,995.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,348.96 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,348.96 | $1,412.54 |
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 $1,862.09 Median $3,019.95 Typical High $3,715.35 | Professional | None | $1,862.09 | $3,019.95 | $3,715.35 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $2,398.83 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,445.44 | $2,398.83 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $2,691.53 Typical High $4,897.79 | Facility | None | $501.19 | $2,691.53 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $3,467.37 | Professional | None | $1,659.59 | $1,949.84 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,754.23 | Professional | None | $2,570.40 | $2,570.40 | $2,754.23 |
Geisinger Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $3,630.78 | Professional | None | $1,659.59 | $2,238.72 | $3,630.78 |
Martin's Point Setting Facility Modifier None Typical Low $1,148.15 Median $5,248.07 Typical High $8,709.64 | Facility | None | $1,148.15 | $5,248.07 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,905.46 | $1,995.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,380.38 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,380.38 | $1,412.54 |
Oscar Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,995.26 | $2,089.30 | $3,801.89 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $4,466.84 | Facility | None | $1,621.81 | $2,630.27 | $4,466.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,621.81 | $1,621.81 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,380.38 | $2,398.83 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,621.81 | $2,137.96 | $3,715.35 |
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 $831.76 Median $954.99 Typical High $1,000.00 | Professional | 52 · Reduced service | $831.76 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $380.19 Typical High $398.11 | Professional | 53 · Discontinued | $331.13 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,445.44 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,258.93 | $1,445.44 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $288.40 Typical High $302.00 | Professional | 55 · Aftercare only | $251.19 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $190.55 Typical High $199.53 | Professional | 56 · Pre-op care only | $165.96 | $190.55 | $199.53 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $4,466.84 Typical High $5,623.41 | Professional | 50 · Both sides | $2,754.23 | $4,466.84 | $5,623.41 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $977.24 Typical High $1,000.00 | Professional | 52 · Reduced service | $831.76 | $977.24 | $1,000.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $389.05 Typical High $398.11 | Professional | 53 · Discontinued | $331.13 | $389.05 | $398.11 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,479.11 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,258.93 | $1,479.11 | $1,513.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $295.12 Typical High $302.00 | Professional | 55 · Aftercare only | $251.19 | $295.12 | $302.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $194.98 Typical High $199.53 | Professional | 56 · Pre-op care only | $165.96 | $194.98 | $199.53 |
Where Pennsylvania sits
The same service costs 6.9 times more in Alaska than in Texas. 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
$1,995
AK $7,586TX $1,096
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.