How much rates vary
Facilitymedian $29 · 10th to 90th $21 to $60Professionalmedian $25 · 10th to 90th $20 to $27
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 $25.12 Median $38.02 Typical High $60.26 | Facility | None | $25.12 | $38.02 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $26.30 | Professional | None | $25.12 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.80 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.51 |
AmeriHealth Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $27.54 | Facility | None | $18.20 | $18.20 | $27.54 |
Capital Blue Cross Setting Facility Modifier None Typical Low $23.44 Median $26.92 Typical High $32.36 | Facility | None | $23.44 | $26.92 | $32.36 |
Capital Blue Cross Setting Professional Modifier None Typical Low $23.44 Median $25.70 Typical High $25.70 | Professional | None | $23.44 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $41.69 Typical High $95.50 | Facility | None | $25.12 | $41.69 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Emblem Health Setting Professional Modifier None Typical Low $25.70 Median $26.92 Typical High $46.77 | Professional | None | $25.70 | $26.92 | $46.77 |
Geisinger Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Geisinger Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $74.13 | Professional | None | $25.12 | $38.02 | $74.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $89.13 Median $173.78 Typical High $190.55 | Facility | None | $89.13 | $173.78 | $190.55 |
Independence Blue Cross Setting Facility Modifier None Typical Low $18.20 Median $25.12 Typical High $28.18 | Facility | None | $18.20 | $25.12 | $28.18 |
Martin's Point Setting Facility Modifier None Typical Low $24.55 Median $38.02 Typical High $60.26 | Facility | None | $24.55 | $38.02 | $60.26 |
Martin's Point Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.80 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.80 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.51 |
Oscar Health Setting Professional Modifier None Typical Low $30.90 Median $72.44 Typical High $72.44 | Professional | None | $30.90 | $72.44 | $72.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $25.12 Median $28.84 Typical High $33.11 | Facility | None | $25.12 | $28.84 | $33.11 |
UPMC Health Plan Setting Professional Modifier None Typical Low $25.12 Median $25.70 Typical High $29.51 | Professional | None | $25.12 | $25.70 | $29.51 |
United Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $74.13 | Professional | None | $15.85 | $17.78 | $74.13 |
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 $16.60 Median $16.60 Typical High $25.12 | Professional | JZ · No drug discarded | $16.60 | $16.60 | $25.12 |
Highmark BCBS Setting Professional Modifier JZ · No drug discarded Typical Low $23.44 Median $52.48 Typical High $63.10 | Professional | JZ · No drug discarded | $23.44 | $52.48 | $63.10 |
Where Pennsylvania sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 27th of 51
$25.12
WY $39.81AZ $20.89
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.