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 $20.42 Median $48.98 Typical High $104.71 | Facility | None | $20.42 | $48.98 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $3.02 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.04 |
Capital Blue Cross Setting Facility Modifier None Typical Low $19.50 Median $21.88 Typical High $26.30 | Facility | None | $19.50 | $21.88 | $26.30 |
Capital Blue Cross Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $33.88 Typical High $77.62 | Facility | None | $20.42 | $33.88 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Geisinger Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Geisinger Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $36.31 | Professional | None | $30.20 | $30.20 | $36.31 |
Martin's Point Setting Facility Modifier None Typical Low $20.42 Median $48.98 Typical High $100.00 | Facility | None | $20.42 | $48.98 | $100.00 |
Martin's Point Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.23 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.07 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $3.02 | $3.09 | $3.09 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.04 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $58.88 | Professional | None | $32.36 | $32.36 | $58.88 |
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 $102.33 Median $102.33 Typical High $102.33 | Facility | JZ · No drug discarded | $102.33 | $102.33 | $102.33 |
Where Pennsylvania sits
The same service costs 3.8 times more in Oklahoma than in Delaware. 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· 50th of 51
$20.42
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.