How much rates vary
Facilitymedian $71 · 10th to 90th $62 to $155Professionalmedian $62 · 10th to 90th $60 to $71
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 $61.66 Median $75.86 Typical High $154.88 | Facility | None | $61.66 | $75.86 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | None | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.17 |
Capital Blue Cross Setting Facility Modifier None Typical Low $57.54 Median $66.07 Typical High $79.43 | Facility | None | $57.54 | $66.07 | $79.43 |
Capital Blue Cross Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | None | $63.10 | $63.10 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $102.33 Typical High $234.42 | Facility | None | $61.66 | $102.33 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Geisinger Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Geisinger Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | None | $91.20 | $91.20 | $109.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $44.67 Median $72.44 Typical High $204.17 | Facility | None | $44.67 | $72.44 | $204.17 |
Independence Blue Cross Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $70.79 | Facility | None | $64.57 | $64.57 | $70.79 |
Martin's Point Setting Facility Modifier None Typical Low $61.66 Median $93.33 Typical High $154.88 | Facility | None | $61.66 | $93.33 | $154.88 |
Martin's Point Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | None | $61.66 | $61.66 | $67.61 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.30 | $12.30 | $12.30 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.17 |
UPMC Health Plan Setting Facility Modifier None Typical Low $60.26 Median $70.79 Typical High $74.13 | Facility | None | $60.26 | $70.79 | $74.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | None | $60.26 | $60.26 | $69.18 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | None | $60.26 | $60.26 | $87.10 |
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 $57.54 Median $79.43 Typical High $257.04 | Facility | JZ · No drug discarded | $57.54 | $79.43 | $257.04 |
Where Pennsylvania sits
The same service costs 1.9 times more in Alaska than in Oklahoma. 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· 43rd of 51
$61.66
AK $110OK $57.54
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.