How much rates vary
Facilitymedian $138 · 10th to 90th $120 to $437Professionalmedian $120 · 10th to 90th $120 to $132
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 $120.23 Median $128.82 Typical High $316.23 | Facility | None | $120.23 | $128.82 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | None | $120.23 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $60.26 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $23.99 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $12.30 |
Capital Blue Cross Setting Facility Modifier None Typical Low $114.82 Median $131.83 Typical High $154.88 | Facility | None | $114.82 | $131.83 | $154.88 |
Capital Blue Cross Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | None | $125.89 | $125.89 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $204.17 Typical High $457.09 | Facility | None | $120.23 | $204.17 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Geisinger Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Geisinger Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $218.78 | Professional | None | $181.97 | $181.97 | $218.78 |
Martin's Point Setting Facility Modifier None Typical Low $120.23 Median $181.97 Typical High $316.23 | Facility | None | $120.23 | $181.97 | $316.23 |
Martin's Point Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | None | $120.23 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $60.26 | $61.66 | $61.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $23.99 | $24.55 | $24.55 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $12.30 |
UPMC Health Plan Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $147.91 | Facility | None | $109.65 | $141.25 | $147.91 |
UPMC Health Plan Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $128.82 | Professional | None | $109.65 | $109.65 | $128.82 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
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 JW · Drug discarded Typical Low $371.54 Median $371.54 Typical High $446.68 | Facility | JW · Drug discarded | $371.54 | $371.54 | $446.68 |
Where Pennsylvania sits
The same service costs 1.7 times more in Arizona than in New Mexico. 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· 20th of 51
$123
AZ $204NM $120
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.