How much rates vary
Facilitymedian $95 · 10th to 90th $83 to $309Professionalmedian $83 · 10th to 90th $81 to $91
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 $83.18 Median $123.03 Typical High $213.80 | Facility | None | $83.18 | $123.03 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | None | $83.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $41.69 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.32 | $8.51 | $8.51 |
Capital Blue Cross Setting Facility Modifier None Typical Low $79.43 Median $91.20 Typical High $107.15 | Facility | None | $79.43 | $91.20 | $107.15 |
Capital Blue Cross Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $91.20 | Professional | None | $87.10 | $87.10 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $141.25 Typical High $323.59 | Facility | None | $83.18 | $141.25 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Geisinger Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Geisinger Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | None | $125.89 | $125.89 | $151.36 |
Martin's Point Setting Facility Modifier None Typical Low $83.18 Median $123.03 Typical High $213.80 | Facility | None | $83.18 | $123.03 | $213.80 |
Martin's Point Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | None | $83.18 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $41.69 | $42.66 | $42.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.32 | $8.51 | $8.51 |
UPMC Health Plan Setting Facility Modifier None Typical Low $72.44 Median $97.72 Typical High $102.33 | Facility | None | $72.44 | $97.72 | $102.33 |
UPMC Health Plan Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | None | $72.44 | $72.44 | $83.18 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $112.20 | Professional | None | $81.28 | $81.28 | $112.20 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier JZ · No drug discarded Typical Low $81.28 Median $81.28 Typical High $104.71 | Facility | JZ · No drug discarded | $81.28 | $81.28 | $104.71 |
Where Pennsylvania sits
The same service costs 1.5 times more in Arizona than in Nebraska. 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· 34th of 51
$83.18
AZ $126NE $81.28
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.