How much rates vary
Facilitymedian $51 · 10th to 90th $44 to $158Professionalmedian $45 · 10th to 90th $44 to $65
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 $43.65 Median $83.18 Typical High $158.49 | Facility | None | $43.65 | $83.18 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $44.67 | Professional | None | $43.65 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $21.88 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $8.71 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.37 | $4.47 | $4.47 |
Capital Blue Cross Setting Facility Modifier None Typical Low $41.69 Median $47.86 Typical High $56.23 | Facility | None | $41.69 | $47.86 | $56.23 |
Capital Blue Cross Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $72.44 Typical High $165.96 | Facility | None | $43.65 | $72.44 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Geisinger Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Geisinger Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | None | $66.07 | $66.07 | $79.43 |
Martin's Point Setting Facility Modifier None Typical Low $43.65 Median $83.18 Typical High $158.49 | Facility | None | $43.65 | $83.18 | $158.49 |
Martin's Point Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $44.67 | Professional | None | $43.65 | $44.67 | $44.67 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $21.88 | $22.39 | $22.39 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $8.71 | $8.91 | $8.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.37 | $4.47 | $4.47 |
UPMC Health Plan Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $69.18 | Facility | None | $51.29 | $51.29 | $69.18 |
UPMC Health Plan Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | None | $60.26 | $60.26 | $69.18 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
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 $316.23 Median $316.23 Typical High $316.23 | Facility | JZ · No drug discarded | $316.23 | $316.23 | $316.23 |
Where Pennsylvania sits
The same service costs 2.0 times more in Alaska than in Wyoming. 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· 41st of 51
$47.86
AK $81.28WY $39.81
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.