How much rates vary
Facilitymedian $69 · 10th to 90th $60 to $219Professionalmedian $62 · 10th to 90th $60 to $85
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 $60.26 Median $117.49 Typical High $234.42 | Facility | None | $60.26 | $117.49 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $9.12 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Capital Blue Cross Setting Facility Modifier None Typical Low $56.23 Median $64.57 Typical High $77.62 | Facility | None | $56.23 | $64.57 | $77.62 |
Capital Blue Cross Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | None | $56.23 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $100.00 Typical High $229.09 | Facility | None | $60.26 | $100.00 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Emblem Health Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $102.33 | Professional | None | $61.66 | $61.66 | $102.33 |
Geisinger Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Geisinger Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $151.36 | Professional | None | $60.26 | $89.13 | $151.36 |
Martin's Point Setting Facility Modifier None Typical Low $60.26 Median $190.55 Typical High $234.42 | Facility | None | $60.26 | $190.55 | $234.42 |
Martin's Point Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $9.12 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $9.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Oscar Health Setting Professional Modifier None Typical Low $30.20 Median $173.78 Typical High $288.40 | Professional | None | $30.20 | $173.78 | $288.40 |
UPMC Health Plan Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $147.91 | Facility | None | $69.18 | $69.18 | $147.91 |
UPMC Health Plan Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $147.91 | Professional | None | $125.89 | $128.82 | $147.91 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $97.72 | Professional | None | $72.44 | $81.28 | $97.72 |
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 JW · Drug discarded + JZ · No drug discarded Typical Low $162.18 Median $162.18 Typical High $407.38 | Facility | JW · Drug discarded + JZ · No drug discarded | $162.18 | $162.18 | $407.38 |
Where Pennsylvania sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 36th of 51
$61.66
HI $158CO $60.26
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.