How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $5Professionalmedian $1 · 10th to 90th $1 to $2
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 $0.81 Median $1.41 Typical High $3.39 | Facility | None | $0.81 | $1.41 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $2.04 | Professional | None | $1.35 | $1.35 | $2.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 52 · Reduced service | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
AmeriHealth Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $1.62 | Facility | None | $1.38 | $1.38 | $1.62 |
AmeriHealth Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1.29 Median $1.45 Typical High $1.74 | Facility | None | $1.29 | $1.45 | $1.74 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Cigna Setting Facility Modifier None Typical Low $1.35 Median $2.24 Typical High $5.13 | Facility | None | $1.35 | $2.24 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Geisinger Setting Facility Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Facility | None | $1.35 | $1.35 | $1.35 |
Geisinger Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.45 | Professional | None | $2.04 | $2.04 | $2.45 |
Highmark BCBS Setting Facility Modifier None Typical Low $2.95 Median $5.37 Typical High $10.47 | Facility | None | $2.95 | $5.37 | $10.47 |
Independence Blue Cross Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $1.62 | Facility | None | $1.38 | $1.38 | $1.62 |
Independence Blue Cross Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Martin's Point Setting Facility Modifier None Typical Low $0.81 Median $1.41 Typical High $3.39 | Facility | None | $0.81 | $1.41 | $3.39 |
Martin's Point Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $2.00 | Professional | None | $1.35 | $1.35 | $2.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 52 · Reduced service | $0.68 | $0.68 | $0.68 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.27 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1.32 Median $1.58 Typical High $1.66 | Facility | None | $1.32 | $1.58 | $1.66 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.51 | Professional | None | $1.32 | $1.32 | $1.51 |
United Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $2.51 | Professional | None | $1.35 | $1.35 | $2.51 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | JZ · No drug discarded | $2.14 | $2.14 | $2.14 |
Where Pennsylvania sits
The same service costs 3.2 times more in Wyoming than in Maine. 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· 23rd of 51
$1.38
WY $4.27ME $1.35
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.