How much rates vary
Facilitymedian $35 · 10th to 90th $30 to $107Professionalmedian $30 · 10th to 90th $29 to $31
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 $29.51 Median $40.74 Typical High $75.86 | Facility | None | $29.51 | $40.74 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $30.20 Typical High $30.20 | Professional | None | $29.51 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $14.79 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $5.89 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 54 · Surgery only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.95 | $3.02 | $3.02 |
Capital Blue Cross Setting Facility Modifier None Typical Low $28.18 Median $32.36 Typical High $38.02 | Facility | None | $28.18 | $32.36 | $38.02 |
Capital Blue Cross Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $50.12 Typical High $114.82 | Facility | None | $29.51 | $50.12 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Geisinger Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Geisinger Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | None | $44.67 | $44.67 | $53.70 |
Martin's Point Setting Facility Modifier None Typical Low $29.51 Median $43.65 Typical High $75.86 | Facility | None | $29.51 | $43.65 | $75.86 |
Martin's Point Setting Professional Modifier None Typical Low $29.51 Median $30.20 Typical High $30.20 | Professional | None | $29.51 | $30.20 | $30.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $14.79 | $15.14 | $15.14 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $5.89 | $6.03 | $6.03 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 54 · Surgery only | $22.39 | $22.39 | $22.39 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.95 | $3.02 | $3.02 |
UPMC Health Plan Setting Facility Modifier None Typical Low $26.30 Median $34.67 Typical High $36.31 | Facility | None | $26.30 | $34.67 | $36.31 |
UPMC Health Plan Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $30.20 | Professional | None | $26.30 | $26.30 | $30.20 |
United Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
United Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $39.81 | Professional | None | $28.84 | $28.84 | $39.81 |
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 $63.10 Median $63.10 Typical High $63.10 | Facility | JZ · No drug discarded | $63.10 | $63.10 | $63.10 |
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· 21st of 51
$30.20
AK $53.70OK $27.54
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.