How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $5Professionalmedian $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 $1.32 Median $1.78 Typical High $3.47 | Facility | None | $1.32 | $1.78 | $3.47 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.35 Typical High $1.35 | Professional | None | $1.32 | $1.35 | $1.35 |
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 $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1.26 Median $1.45 Typical High $1.70 | Facility | None | $1.26 | $1.45 | $1.70 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Cigna Setting Facility Modifier None Typical Low $1.32 Median $2.24 Typical High $5.13 | Facility | None | $1.32 | $2.24 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Geisinger Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
Geisinger Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.40 | Professional | None | $2.00 | $2.00 | $2.40 |
Martin's Point Setting Facility Modifier None Typical Low $1.32 Median $2.00 Typical High $3.47 | Facility | None | $1.32 | $2.00 | $3.47 |
Martin's Point Setting Professional Modifier None Typical Low $1.32 Median $1.35 Typical High $1.35 | Professional | None | $1.32 | $1.35 | $1.35 |
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 $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
UPMC Health Plan Setting Facility Modifier None Typical Low $1.20 Median $1.55 Typical High $1.62 | Facility | None | $1.20 | $1.55 | $1.62 |
UPMC Health Plan Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.38 | Professional | None | $1.20 | $1.20 | $1.38 |
United Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $2.09 | Professional | None | $1.32 | $1.32 | $2.09 |
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 $3.31 Median $3.31 Typical High $4.17 | Facility | JZ · No drug discarded | $3.31 | $3.31 | $4.17 |
Where Pennsylvania sits
The same service costs 1.5 times more in Alaska than in Virginia. 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· 25th of 51
$1.35
AK $2.00VA $1.32
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.