How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $2Professionalmedian $1 · 10th to 90th $1 to $1
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 $0.56 Median $0.87 Typical High $6.03 | Facility | None | $0.56 | $0.87 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.58 Typical High $0.60 | Professional | None | $0.56 | $0.58 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
AmeriHealth Setting Facility Modifier None Typical Low $0.38 Median $0.38 Typical High $0.45 | Facility | None | $0.38 | $0.38 | $0.45 |
AmeriHealth Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $5.13 | Professional | None | $0.37 | $0.37 | $5.13 |
Capital Blue Cross Setting Facility Modifier None Typical Low $0.54 Median $0.62 Typical High $0.74 | Facility | None | $0.54 | $0.62 | $0.74 |
Capital Blue Cross Setting Professional Modifier None Typical Low $0.54 Median $0.60 Typical High $0.60 | Professional | None | $0.54 | $0.60 | $0.60 |
Cigna Setting Facility Modifier None Typical Low $0.56 Median $0.91 Typical High $2.09 | Facility | None | $0.56 | $0.91 | $2.09 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Emblem Health Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $5.37 | Professional | None | $0.55 | $0.55 | $5.37 |
Geisinger Setting Facility Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Facility | None | $0.58 | $0.58 | $0.58 |
Geisinger Setting Professional Modifier None Typical Low $0.58 Median $0.68 Typical High $1.15 | Professional | None | $0.58 | $0.68 | $1.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $1.62 Median $2.63 Typical High $8.71 | Facility | None | $1.62 | $2.63 | $8.71 |
Highmark BCBS Setting Professional Modifier None Typical Low $0.41 Median $0.62 Typical High $0.69 | Professional | None | $0.41 | $0.62 | $0.69 |
Independence Blue Cross Setting Facility Modifier None Typical Low $0.38 Median $0.38 Typical High $0.45 | Facility | None | $0.38 | $0.38 | $0.45 |
Independence Blue Cross Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $2.29 | Professional | None | $0.37 | $0.37 | $2.29 |
Martin's Point Setting Facility Modifier None Typical Low $0.56 Median $0.87 Typical High $1.35 | Facility | None | $0.56 | $0.87 | $1.35 |
Martin's Point Setting Professional Modifier None Typical Low $0.56 Median $0.58 Typical High $0.60 | Professional | None | $0.56 | $0.58 | $0.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Oscar Health Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $1.91 | Professional | None | $0.60 | $0.60 | $1.91 |
UPMC Health Plan Setting Facility Modifier None Typical Low $0.68 Median $0.68 Typical High $1.17 | Facility | None | $0.68 | $0.68 | $1.17 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1.00 Median $1.02 Typical High $1.17 | Professional | None | $1.00 | $1.02 | $1.17 |
United Setting Professional Modifier None Typical Low $0.60 Median $0.68 Typical High $0.78 | Professional | None | $0.60 | $0.68 | $0.78 |
2 more rates 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | JZ · No drug discarded | $2.00 | $2.00 | $2.00 |
Highmark BCBS Setting Professional Modifier JZ · No drug discarded Typical Low $0.40 Median $0.56 Typical High $0.74 | Professional | JZ · No drug discarded | $0.40 | $0.56 | $0.74 |
Where Pennsylvania sits
The same service costs 1.9 times more in Wyoming 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
$0.60
WY $1.07OK $0.55
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.