How much rates vary
Facilitymedian $123 · 10th to 90th $105 to $380Professionalmedian $110 · 10th to 90th $105 to $129
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 $104.71 Median $229.09 Typical High $501.19 | Facility | None | $104.71 | $229.09 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | None | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | 53 · Discontinued | $20.89 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.72 |
Capital Blue Cross Setting Facility Modifier None Typical Low $100.00 Median $114.82 Typical High $134.90 | Facility | None | $100.00 | $114.82 | $134.90 |
Capital Blue Cross Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | None | $97.72 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $173.78 Typical High $398.11 | Facility | None | $104.71 | $173.78 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $269.15 | Professional | None | $109.65 | $114.82 | $269.15 |
Geisinger Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Geisinger Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $758.58 | Professional | None | $104.71 | $151.36 | $758.58 |
Martin's Point Setting Facility Modifier None Typical Low $104.71 Median $229.09 Typical High $501.19 | Facility | None | $104.71 | $229.09 | $501.19 |
Martin's Point Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | None | $104.71 | $104.71 | $107.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | 53 · Discontinued | $20.89 | $20.89 | $21.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.72 |
Oscar Health Setting Professional Modifier None Typical Low $0.60 Median $30.20 Typical High $446.68 | Professional | None | $0.60 | $30.20 | $446.68 |
UPMC Health Plan Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $257.04 | Facility | None | $123.03 | $123.03 | $257.04 |
UPMC Health Plan Setting Professional Modifier None Typical Low $218.78 Median $223.87 Typical High $257.04 | Professional | None | $218.78 | $223.87 | $257.04 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $154.88 | Professional | None | $114.82 | $128.82 | $154.88 |
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 $251.19 Median $251.19 Typical High $380.19 | Facility | JZ · No drug discarded | $251.19 | $251.19 | $380.19 |
Where Pennsylvania sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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· 27th of 51
$110
WY $204VT $105
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.