How much rates vary
Facilitymedian $3 · 10th to 90th $3 to $7Professionalmedian $3 · 10th to 90th $3 to $3
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 $2.95 Median $3.63 Typical High $6.76 | Facility | None | $2.95 | $3.63 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.09 | Professional | None | $2.95 | $2.95 | $3.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.45 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.30 |
Ambetter Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
AmeriHealth Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.63 | Facility | None | $3.16 | $3.16 | $3.63 |
AmeriHealth Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $3.16 | Professional | None | $2.82 | $2.82 | $3.16 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2.82 Median $3.16 Typical High $3.80 | Facility | None | $2.82 | $3.16 | $3.80 |
Capital Blue Cross Setting Professional Modifier None Typical Low $2.75 Median $3.02 Typical High $3.02 | Professional | None | $2.75 | $3.02 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $4.90 Typical High $11.22 | Facility | None | $2.95 | $4.90 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Emblem Health Setting Professional Modifier None Typical Low $0.72 Median $3.16 Typical High $4.27 | Professional | None | $0.72 | $3.16 | $4.27 |
Geisinger Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Facility | None | $2.95 | $2.95 | $2.95 |
Geisinger Setting Professional Modifier None Typical Low $2.24 Median $3.39 Typical High $5.89 | Professional | None | $2.24 | $3.39 | $5.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.80 Median $6.03 Typical High $29.51 | Facility | None | $3.80 | $6.03 | $29.51 |
Independence Blue Cross Setting Facility Modifier None Typical Low $2.82 Median $2.88 Typical High $3.39 | Facility | None | $2.82 | $2.88 | $3.39 |
Independence Blue Cross Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.88 | Professional | None | $2.82 | $2.82 | $2.88 |
Martin's Point Setting Facility Modifier None Typical Low $2.95 Median $3.98 Typical High $6.76 | Facility | None | $2.95 | $3.98 | $6.76 |
Martin's Point Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.48 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.45 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.45 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.30 |
Oscar Health Setting Professional Modifier None Typical Low $3.80 Median $5.01 Typical High $5.01 | Professional | None | $3.80 | $5.01 | $5.01 |
UPMC Health Plan Setting Facility Modifier None Typical Low $2.19 Median $3.39 Typical High $3.63 | Facility | None | $2.19 | $3.39 | $3.63 |
UPMC Health Plan Setting Professional Modifier None Typical Low $2.19 Median $2.24 Typical High $2.51 | Professional | None | $2.19 | $2.24 | $2.51 |
United Setting Professional Modifier None Typical Low $2.51 Median $2.82 Typical High $3.47 | Professional | None | $2.51 | $2.82 | $3.47 |
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 Professional Modifier JZ · No drug discarded Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | JZ · No drug discarded | $2.75 | $2.75 | $2.75 |
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· 40th of 51
$2.95
AK $3.98NC $2.69
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.