How much rates vary
Facilitymedian $37 · 10th to 90th $29 to $107Professionalmedian $29 · 10th to 90th $25 to $30
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 $28.84 Median $69.18 Typical High $93.33 | Facility | None | $28.84 | $69.18 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
Capital Blue Cross Setting Facility Modifier None Typical Low $27.54 Median $30.90 Typical High $5,011.87 | Facility | None | $27.54 | $30.90 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $26.92 Median $30.20 Typical High $30.20 | Professional | None | $26.92 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $47.86 Typical High $109.65 | Facility | None | $28.84 | $47.86 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Emblem Health Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $74.13 | Professional | None | $30.20 | $30.90 | $74.13 |
Geisinger Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Geisinger Setting Professional Modifier None Typical Low $19.50 Median $31.62 Typical High $57.54 | Professional | None | $19.50 | $31.62 | $57.54 |
Martin's Point Setting Facility Modifier None Typical Low $28.84 Median $69.18 Typical High $104.71 | Facility | None | $28.84 | $69.18 | $104.71 |
Martin's Point Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
Oscar Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $44.67 | Professional | None | $38.02 | $38.02 | $44.67 |
UPMC Health Plan Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $47.86 | Facility | None | $33.11 | $33.11 | $47.86 |
UPMC Health Plan Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $47.86 | Professional | None | $41.69 | $42.66 | $47.86 |
United Setting Professional Modifier None Typical Low $23.44 Median $26.30 Typical High $31.62 | Professional | None | $23.44 | $26.30 | $31.62 |
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 $83.18 Median $257.04 Typical High $489.78 | Facility | JZ · No drug discarded | $83.18 | $257.04 | $489.78 |
Where Pennsylvania sits
The same service costs 2.5 times more in Wyoming than in Maryland. 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· 22nd of 51
$28.84
WY $67.61MD $27.54
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.