How much rates vary
Facilitymedian $708 · 10th to 90th $240 to $6,166Professionalmedian $776 · 10th to 90th $661 to $1,349
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 $4,897.79 Typical High $8,511.38 | Facility | None | $724.44 | $4,897.79 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $870.96 | Professional | None | $691.83 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $512.86 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $512.86 | $602.56 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $5,011.87 Typical High $56,234.13 | Facility | None | $3,981.07 | $5,011.87 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,380.38 | Professional | None | $758.58 | $1,122.02 | $1,380.38 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $912.01 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $616.60 | $912.01 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $660.69 Typical High $2,290.87 | Facility | None | $380.19 | $660.69 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,621.81 | Professional | None | $851.14 | $1,148.15 | $1,621.81 |
Geisinger Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,318.26 | Professional | None | $707.95 | $851.14 | $1,318.26 |
Martin's Point Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $8,709.64 | Facility | None | $831.76 | $3,801.89 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $870.96 | Professional | None | $691.83 | $758.58 | $870.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,412.54 | $1,412.54 |
UPMC Health Plan Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $741.31 | Facility | None | $588.84 | $588.84 | $741.31 |
UPMC Health Plan Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $741.31 | Professional | None | $588.84 | $741.31 | $741.31 |
United Setting Facility Modifier None Typical Low $199.53 Median $562.34 Typical High $4,265.80 | Facility | None | $199.53 | $562.34 | $4,265.80 |
United Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,122.02 | Professional | None | $588.84 | $691.83 | $1,122.02 |
6 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 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $575.44 | $645.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $87.10 |
Where Pennsylvania sits
The same service costs 3.8 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· 26th of 51
$776
AK $1,862TX $490
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.