How much rates vary
Facilitymedian $13 · 10th to 90th $11 to $33Professionalmedian $11 · 10th to 90th $11 to $14
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 $11.48 Median $17.38 Typical High $33.11 | Facility | None | $11.48 | $17.38 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | None | $11.48 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $5.75 Typical High $5.75 | Professional | 52 · Reduced service | $5.62 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.70 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.15 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.12 | $1.15 | $1.15 |
Capital Blue Cross Setting Facility Modifier None Typical Low $10.72 Median $12.30 Typical High $14.79 | Facility | None | $10.72 | $12.30 | $14.79 |
Capital Blue Cross Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | None | $11.75 | $11.75 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $19.05 Typical High $43.65 | Facility | None | $11.48 | $19.05 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Geisinger Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Geisinger Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $20.42 | Professional | None | $16.98 | $16.98 | $20.42 |
Martin's Point Setting Facility Modifier None Typical Low $11.22 Median $17.78 Typical High $33.11 | Facility | None | $11.22 | $17.78 | $33.11 |
Martin's Point Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | None | $11.48 | $11.48 | $12.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $5.75 Typical High $5.75 | Professional | 52 · Reduced service | $5.62 | $5.75 | $5.75 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.70 | $1.74 | $1.74 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.15 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.12 | $1.15 | $1.15 |
UPMC Health Plan Setting Facility Modifier None Typical Low $12.30 Median $13.18 Typical High $14.13 | Facility | None | $12.30 | $13.18 | $14.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $14.13 | Professional | None | $12.30 | $12.30 | $14.13 |
United Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $20.42 | Professional | None | $11.75 | $11.75 | $20.42 |
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 $26.30 Median $41.69 Typical High $83.18 | Facility | JZ · No drug discarded | $26.30 | $41.69 | $83.18 |
Where Pennsylvania sits
The same service costs 1.8 times more in Alaska than in Georgia. 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· 40th of 51
$11.75
AK $20.89GA $11.48
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.