How much rates vary
Facilitymedian $6 · 10th to 90th $5 to $20Professionalmedian $5 · 10th to 90th $5 to $7
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 $5.50 Median $8.32 Typical High $14.45 | Facility | None | $5.50 | $8.32 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 52 · Reduced service | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.81 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $0.55 |
Capital Blue Cross Setting Facility Modifier None Typical Low $5.13 Median $5.89 Typical High $7.08 | Facility | None | $5.13 | $5.89 | $7.08 |
Capital Blue Cross Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $9.12 Typical High $20.89 | Facility | None | $5.50 | $9.12 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Geisinger Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Geisinger Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.77 | Professional | None | $8.13 | $8.13 | $9.77 |
Independence Blue Cross Setting Facility Modifier None Typical Low $5.75 Median $6.31 Typical High $6.61 | Facility | None | $5.75 | $6.31 | $6.61 |
Martin's Point Setting Facility Modifier None Typical Low $5.50 Median $8.32 Typical High $14.45 | Facility | None | $5.50 | $8.32 | $14.45 |
Martin's Point Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 52 · Reduced service | $2.75 | $2.75 | $2.75 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.81 | $0.83 | $0.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $0.55 |
UPMC Health Plan Setting Facility Modifier None Typical Low $5.01 Median $6.31 Typical High $6.76 | Facility | None | $5.01 | $6.31 | $6.76 |
UPMC Health Plan Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.75 | Professional | None | $5.01 | $5.01 | $5.75 |
United Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
United Setting Professional Modifier None Typical Low $5.50 Median $5.89 Typical High $7.76 | Professional | None | $5.50 | $5.89 | $7.76 |
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 $6.17 Median $6.17 Typical High $6.17 | Facility | JZ · No drug discarded | $6.17 | $6.17 | $6.17 |
Where Pennsylvania sits
The same service costs 1.9 times more in Alaska than in New Mexico. 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· 48th of 51
$5.50
AK $10.23NM $5.50
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.