How much rates vary
Facilitymedian $10 · 10th to 90th $8 to $32Professionalmedian $9 · 10th to 90th $8 to $10
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 $8.13 Median $19.50 Typical High $46.77 | Facility | None | $8.13 | $19.50 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.32 | Professional | None | $8.13 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.07 Typical High $4.17 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.66 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.83 |
Capital Blue Cross Setting Facility Modifier None Typical Low $7.76 Median $8.91 Typical High $10.47 | Facility | None | $7.76 | $8.91 | $10.47 |
Capital Blue Cross Setting Professional Modifier None Typical Low $7.59 Median $8.51 Typical High $8.51 | Professional | None | $7.59 | $8.51 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $13.80 Typical High $31.62 | Facility | None | $8.13 | $13.80 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Emblem Health Setting Professional Modifier None Typical Low $8.51 Median $8.91 Typical High $38.02 | Professional | None | $8.51 | $8.91 | $38.02 |
Geisinger Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Geisinger Setting Professional Modifier None Typical Low $8.51 Median $17.38 Typical High $51.29 | Professional | None | $8.51 | $17.38 | $51.29 |
Highmark BCBS Setting Facility Modifier None Typical Low $10.96 Median $19.50 Typical High $20.42 | Facility | None | $10.96 | $19.50 | $20.42 |
Martin's Point Setting Facility Modifier None Typical Low $8.13 Median $19.50 Typical High $52.48 | Facility | None | $8.13 | $19.50 | $52.48 |
Martin's Point Setting Professional Modifier None Typical Low $8.13 Median $8.32 Typical High $8.32 | Professional | None | $8.13 | $8.32 | $8.32 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.07 Typical High $4.17 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.17 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.66 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.66 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.83 |
Oscar Health Setting Professional Modifier None Typical Low $33.88 Median $63.10 Typical High $63.10 | Professional | None | $33.88 | $63.10 | $63.10 |
UPMC Health Plan Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $26.92 | Facility | None | $9.55 | $9.55 | $26.92 |
UPMC Health Plan Setting Professional Modifier None Typical Low $22.91 Median $23.44 Typical High $26.92 | Professional | None | $22.91 | $23.44 | $26.92 |
United Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $8.32 Median $9.33 Typical High $11.22 | Professional | None | $8.32 | $9.33 | $11.22 |
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 $8.13 Median $8.13 Typical High $8.13 | Professional | JZ · No drug discarded | $8.13 | $8.13 | $8.13 |
Where Pennsylvania sits
The same service costs 1.9 times more in Wyoming 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· 29th of 51
$8.51
WY $15.49GA $8.13
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.