How much rates vary
Facilitymedian $219 · 10th to 90th $191 to $490Professionalmedian $191 · 10th to 90th $178 to $200
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 $190.55 Median $257.04 Typical High $489.78 | Facility | None | $190.55 | $257.04 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | None | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Capital Blue Cross Setting Facility Modifier None Typical Low $181.97 Median $208.93 Typical High $245.47 | Facility | None | $181.97 | $208.93 | $245.47 |
Capital Blue Cross Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | None | $177.83 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $724.44 | Facility | None | $190.55 | $316.23 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $186.21 Typical High $275.42 | Professional | None | $181.97 | $186.21 | $275.42 |
Geisinger Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Geisinger Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $323.59 | Professional | None | $125.89 | $199.53 | $323.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $144.54 Median $186.21 Typical High $426.58 | Facility | None | $144.54 | $186.21 | $426.58 |
Highmark BCBS Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | None | $186.21 | $186.21 | $204.17 |
Independence Blue Cross Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $234.42 | Facility | None | $204.17 | $204.17 | $234.42 |
Martin's Point Setting Facility Modifier None Typical Low $190.55 Median $269.15 Typical High $489.78 | Facility | None | $190.55 | $269.15 | $489.78 |
Martin's Point Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Oscar Health Setting Professional Modifier None Typical Low $0.60 Median $218.78 Typical High $363.08 | Professional | None | $0.60 | $218.78 | $363.08 |
UPMC Health Plan Setting Facility Modifier None Typical Low $165.96 Median $218.78 Typical High $234.42 | Facility | None | $165.96 | $218.78 | $234.42 |
UPMC Health Plan Setting Professional Modifier None Typical Low $165.96 Median $169.82 Typical High $190.55 | Professional | None | $165.96 | $169.82 | $190.55 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $208.93 | Professional | None | $173.78 | $199.53 | $208.93 |
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 JW · Drug discarded Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | JW · Drug discarded | $186.21 | $186.21 | $186.21 |
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· 36th of 51
$191
AK $234MA $191
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.