How much rates vary
Facilitymedian $457 · 10th to 90th $389 to $1,445Professionalmedian $398 · 10th to 90th $389 to $457
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 $389.05 Median $575.44 Typical High $1,023.29 | Facility | None | $389.05 | $575.44 | $1,023.29 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | None | $389.05 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $39.81 |
Capital Blue Cross Setting Facility Modifier None Typical Low $371.54 Median $426.58 Typical High $501.19 | Facility | None | $371.54 | $426.58 | $501.19 |
Capital Blue Cross Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $660.69 Typical High $1,513.56 | Facility | None | $389.05 | $660.69 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Geisinger Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Geisinger Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | None | $588.84 | $588.84 | $707.95 |
Martin's Point Setting Facility Modifier None Typical Low $389.05 Median $575.44 Typical High $1,023.29 | Facility | None | $389.05 | $575.44 | $1,023.29 |
Martin's Point Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | None | $389.05 | $398.11 | $398.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $194.98 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $39.81 |
UPMC Health Plan Setting Facility Modifier None Typical Low $389.05 Median $457.09 Typical High $478.63 | Facility | None | $389.05 | $457.09 | $478.63 |
UPMC Health Plan Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | None | $389.05 | $389.05 | $457.09 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $537.03 | Professional | None | $380.19 | $407.38 | $537.03 |
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 $371.54 Median $371.54 Typical High $371.54 | Facility | JZ · No drug discarded | $371.54 | $371.54 | $371.54 |
Where Pennsylvania sits
The same service costs 1.9 times more in Texas than in Illinois. 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· 30th of 51
$398
TX $741IL $389
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.