How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $3Professionalmedian $1 · 10th to 90th $1 to $1
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 $0.85 Median $1.51 Typical High $7.41 | Facility | None | $0.85 | $1.51 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $0.85 Median $0.87 Typical High $0.87 | Professional | None | $0.85 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.43 Median $0.44 Typical High $0.44 | Professional | 52 · Reduced service | $0.43 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Capital Blue Cross Setting Facility Modifier None Typical Low $0.81 Median $0.93 Typical High $1.12 | Facility | None | $0.81 | $0.93 | $1.12 |
Capital Blue Cross Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Cigna Setting Facility Modifier None Typical Low $0.87 Median $1.45 Typical High $3.31 | Facility | None | $0.87 | $1.45 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
Geisinger Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Facility | None | $0.85 | $0.85 | $0.85 |
Geisinger Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.55 | Professional | None | $1.29 | $1.29 | $1.55 |
Martin's Point Setting Facility Modifier None Typical Low $0.85 Median $1.62 Typical High $7.41 | Facility | None | $0.85 | $1.62 | $7.41 |
Martin's Point Setting Professional Modifier None Typical Low $0.85 Median $0.87 Typical High $0.87 | Professional | None | $0.85 | $0.87 | $0.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.43 Median $0.44 Typical High $0.44 | Professional | 52 · Reduced service | $0.43 | $0.44 | $0.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.17 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1.00 Median $1.00 Typical High $1.07 | Facility | None | $1.00 | $1.00 | $1.07 |
United Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Facility | None | $0.85 | $0.85 | $0.85 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.86 | Professional | None | $1.00 | $1.00 | $1.86 |
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 $1.86 Median $1.86 Typical High $1.86 | Facility | JZ · No drug discarded | $1.86 | $1.86 | $1.86 |
Where Pennsylvania sits
The same service costs 4.1 times more in Oklahoma than in North Dakota. 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· 45th of 51
$0.87
OK $3.47ND $0.85
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.