How much rates vary
Facilitymedian $25 · 10th to 90th $21 to $71Professionalmedian $21 · 10th to 90th $21 to $26
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 $20.89 Median $23.44 Typical High $60.26 | Facility | None | $20.89 | $23.44 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $26.30 | Professional | None | $20.89 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $10.47 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.09 | $2.14 | $2.14 |
Capital Blue Cross Setting Facility Modifier None Typical Low $19.95 Median $22.91 Typical High $26.92 | Facility | None | $19.95 | $22.91 | $26.92 |
Capital Blue Cross Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $35.48 Typical High $81.28 | Facility | None | $20.89 | $35.48 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Geisinger Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Geisinger Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | None | $31.62 | $31.62 | $38.02 |
Highmark BCBS Setting Facility Modifier None Typical Low $30.90 Median $45.71 Typical High $64.57 | Facility | None | $30.90 | $45.71 | $64.57 |
Independence Blue Cross Setting Facility Modifier None Typical Low $22.91 Median $25.12 Typical High $26.30 | Facility | None | $22.91 | $25.12 | $26.30 |
Martin's Point Setting Facility Modifier None Typical Low $20.89 Median $29.51 Typical High $60.26 | Facility | None | $20.89 | $29.51 | $60.26 |
Martin's Point Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $23.44 | Professional | None | $20.89 | $21.38 | $23.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $10.47 | $10.72 | $10.72 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.27 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.09 | $2.14 | $2.14 |
UPMC Health Plan Setting Facility Modifier None Typical Low $22.91 Median $24.55 Typical High $26.30 | Facility | None | $22.91 | $24.55 | $26.30 |
UPMC Health Plan Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $26.30 | Professional | None | $22.91 | $22.91 | $26.30 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $38.90 | Professional | None | $21.88 | $21.88 | $38.90 |
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 $24.55 Median $56.23 Typical High $100.00 | Facility | JZ · No drug discarded | $24.55 | $56.23 | $100.00 |
Where Pennsylvania sits
The same service costs 2.6 times more in Wyoming than in Texas. 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· 28th of 51
$21.88
WY $38.90TX $14.79
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.