How much rates vary
Facilitymedian $324 · 10th to 90th $282 to $741Professionalmedian $282 · 10th to 90th $245 to $288
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 $281.84 Median $309.03 Typical High $707.95 | Facility | None | $281.84 | $309.03 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 52 · Reduced service | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
Capital Blue Cross Setting Facility Modifier None Typical Low $263.03 Median $302.00 Typical High $363.08 | Facility | None | $263.03 | $302.00 | $363.08 |
Capital Blue Cross Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | None | $263.03 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $467.74 Typical High $1,071.52 | Facility | None | $281.84 | $467.74 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $407.38 | Professional | None | $269.15 | $275.42 | $407.38 |
Geisinger Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Geisinger Setting Professional Modifier None Typical Low $100.00 Median $281.84 Typical High $467.74 | Professional | None | $100.00 | $281.84 | $467.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $707.95 | Facility | None | $616.60 | $616.60 | $707.95 |
Martin's Point Setting Facility Modifier None Typical Low $281.84 Median $309.03 Typical High $707.95 | Facility | None | $281.84 | $309.03 | $707.95 |
Martin's Point Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 52 · Reduced service | $138.04 | $138.04 | $141.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $42.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
Oscar Health Setting Professional Modifier None Typical Low $0.60 Median $181.97 Typical High $446.68 | Professional | None | $0.60 | $181.97 | $446.68 |
UPMC Health Plan Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $338.84 | Facility | None | $213.80 | $323.59 | $338.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $213.80 Median $218.78 Typical High $245.47 | Professional | None | $213.80 | $218.78 | $245.47 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $302.00 | Professional | None | $245.47 | $281.84 | $302.00 |
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 JW · Drug discarded Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | JW · Drug discarded | $281.84 | $281.84 | $281.84 |
Highmark BCBS Setting Professional Modifier JW · Drug discarded Typical Low $173.78 Median $173.78 Typical High $251.19 | Professional | JW · Drug discarded | $173.78 | $173.78 | $251.19 |
Where Pennsylvania sits
Rates are fairly even across states for this service. 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· 32nd of 51
$282
AK $339NC $275
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.