How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $4Professionalmedian $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 $1.00 Median $1.78 Typical High $2.63 | Facility | None | $1.00 | $1.78 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.02 Typical High $1.12 | Professional | None | $1.00 | $1.02 | $1.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.51 Median $0.51 Typical High $0.51 | Professional | 52 · Reduced service | $0.51 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 53 · Discontinued | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Capital Blue Cross Setting Facility Modifier None Typical Low $0.95 Median $1.10 Typical High $1.29 | Facility | None | $0.95 | $1.10 | $1.29 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | None | $1.05 | $1.05 | $1.05 |
Cigna Setting Facility Modifier None Typical Low $1.00 Median $1.70 Typical High $3.89 | Facility | None | $1.00 | $1.70 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Geisinger Setting Facility Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Facility | None | $1.00 | $1.00 | $1.00 |
Geisinger Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.82 | Professional | None | $1.51 | $1.51 | $1.82 |
Martin's Point Setting Facility Modifier None Typical Low $1.00 Median $1.78 Typical High $2.63 | Facility | None | $1.00 | $1.78 | $2.63 |
Martin's Point Setting Professional Modifier None Typical Low $1.00 Median $1.02 Typical High $1.12 | Professional | None | $1.00 | $1.02 | $1.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.51 Median $0.51 Typical High $0.51 | Professional | 52 · Reduced service | $0.51 | $0.51 | $0.51 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 53 · Discontinued | $0.20 | $0.20 | $0.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
UPMC Health Plan Setting Facility Modifier None Typical Low $0.98 Median $1.17 Typical High $1.23 | Facility | None | $0.98 | $1.17 | $1.23 |
UPMC Health Plan Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $1.12 | Professional | None | $0.98 | $0.98 | $1.12 |
United Setting Facility Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Facility | None | $1.00 | $1.00 | $1.00 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.10 Typical High $1.45 | Professional | None | $1.02 | $1.10 | $1.45 |
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 $1.00 Median $2.34 Typical High $6.61 | Facility | JZ · No drug discarded | $1.00 | $2.34 | $6.61 |
Where Pennsylvania sits
The same service costs 1.6 times more in Arizona than in New Jersey. 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
$1.02
AZ $1.58NJ $1.00
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.