How much rates vary
Facilitymedian $15 · 10th to 90th $13 to $48Professionalmedian $13 · 10th to 90th $13 to $15
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 $13.18 Median $19.95 Typical High $35.48 | Facility | None | $13.18 | $19.95 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.49 Typical High $14.45 | Professional | None | $13.18 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.61 Median $6.76 Typical High $6.76 | Professional | 52 · Reduced service | $6.61 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $2.63 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.35 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.32 | $1.35 | $1.35 |
Capital Blue Cross Setting Facility Modifier None Typical Low $12.59 Median $14.45 Typical High $16.98 | Facility | None | $12.59 | $14.45 | $16.98 |
Capital Blue Cross Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $22.39 Typical High $51.29 | Facility | None | $13.18 | $22.39 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Geisinger Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Geisinger Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $23.99 | Professional | None | $19.95 | $19.95 | $23.99 |
Martin's Point Setting Facility Modifier None Typical Low $13.18 Median $21.38 Typical High $35.48 | Facility | None | $13.18 | $21.38 | $35.48 |
Martin's Point Setting Professional Modifier None Typical Low $13.18 Median $13.49 Typical High $15.14 | Professional | None | $13.18 | $13.49 | $15.14 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.61 Median $6.76 Typical High $6.76 | Professional | 52 · Reduced service | $6.61 | $6.76 | $6.76 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $2.63 | $2.69 | $2.69 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.35 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.32 | $1.35 | $1.35 |
UPMC Health Plan Setting Facility Modifier None Typical Low $12.59 Median $15.49 Typical High $16.22 | Facility | None | $12.59 | $15.49 | $16.22 |
UPMC Health Plan Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $14.45 | Professional | None | $12.59 | $12.59 | $14.45 |
United Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
United Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $18.20 | Professional | None | $13.18 | $13.18 | $18.20 |
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 $14.45 Median $14.45 Typical High $14.45 | Facility | JZ · No drug discarded | $14.45 | $14.45 | $14.45 |
Where Pennsylvania sits
The same service costs 1.5 times more in Alaska than in Delaware. 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· 25th of 51
$13.49
AK $19.95DE $13.18
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.