How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $3Professionalmedian $1 · 10th to 90th $1 to $2
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 $1.12 Median $1.48 Typical High $2.95 | Facility | None | $1.12 | $1.48 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.74 | Professional | None | $1.12 | $1.12 | $1.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 53 · Discontinued | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1.07 Median $1.23 Typical High $1.45 | Facility | None | $1.07 | $1.23 | $1.45 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
Cigna Setting Facility Modifier None Typical Low $1.12 Median $1.91 Typical High $4.37 | Facility | None | $1.12 | $1.91 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Geisinger Setting Facility Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Facility | None | $1.12 | $1.12 | $1.12 |
Geisinger Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $2.04 | Professional | None | $1.70 | $1.70 | $2.04 |
Highmark BCBS Setting Facility Modifier None Typical Low $1.70 Median $2.45 Typical High $3.39 | Facility | None | $1.70 | $2.45 | $3.39 |
Independence Blue Cross Setting Facility Modifier None Typical Low $1.20 Median $1.32 Typical High $1.38 | Facility | None | $1.20 | $1.32 | $1.38 |
Martin's Point Setting Facility Modifier None Typical Low $1.12 Median $1.48 Typical High $2.95 | Facility | None | $1.12 | $1.48 | $2.95 |
Martin's Point Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.74 | Professional | None | $1.12 | $1.12 | $1.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 53 · Discontinued | $0.23 | $0.23 | $0.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1.10 Median $1.32 Typical High $1.38 | Facility | None | $1.10 | $1.32 | $1.38 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.29 | Professional | None | $1.10 | $1.10 | $1.29 |
United Setting Facility Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Facility | None | $1.12 | $1.12 | $1.12 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $2.00 | Professional | None | $1.10 | $1.10 | $2.00 |
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 $1.26 Median $2.57 Typical High $3.63 | Facility | JZ · No drug discarded | $1.26 | $2.57 | $3.63 |
Where Pennsylvania sits
The same service costs 2.2 times more in Wyoming than in Rhode Island. 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· 32nd of 51
$1.12
WY $2.40RI $1.10
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.