How much rates vary
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 $47.86 Median $47.86 Typical High $131.83 | Facility | None | $47.86 | $47.86 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $4.79 |
Capital Blue Cross Setting Facility Modifier None Typical Low $309.03 Median $354.81 Typical High $416.87 | Facility | None | $309.03 | $354.81 | $416.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $79.43 Typical High $181.97 | Facility | None | $47.86 | $79.43 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Martin's Point Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $131.83 | Facility | None | $47.86 | $47.86 | $131.83 |
Martin's Point Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $23.99 | $23.99 | $23.99 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $9.55 | $9.55 | $9.55 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.08 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $4.79 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $85.11 | Professional | None | $46.77 | $46.77 | $85.11 |
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 $29.51 Median $309.03 Typical High $354.81 | Facility | JZ · No drug discarded | $29.51 | $309.03 | $354.81 |
Where Pennsylvania sits
The same service costs 3.9 times more in Hawaii than in South Carolina. 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· 33rd of 51
$47.86
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.