How much rates vary
Facilitymedian $380 · 10th to 90th $331 to $1,202Professionalmedian $331 · 10th to 90th $309 to $339
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 $331.13 Median $489.78 Typical High $851.14 | Facility | None | $331.13 | $489.78 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
Capital Blue Cross Setting Facility Modifier None Typical Low $316.23 Median $354.81 Typical High $426.58 | Facility | None | $316.23 | $354.81 | $426.58 |
Capital Blue Cross Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | None | $309.03 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $549.54 Typical High $1,258.93 | Facility | None | $331.13 | $549.54 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $478.63 | Professional | None | $338.84 | $354.81 | $478.63 |
Geisinger Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Geisinger Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $588.84 | Professional | None | $281.84 | $346.74 | $588.84 |
Martin's Point Setting Facility Modifier None Typical Low $331.13 Median $660.69 Typical High $851.14 | Facility | None | $331.13 | $660.69 | $851.14 |
Martin's Point Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $50.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
Oscar Health Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $630.96 | Professional | None | $0.60 | $0.60 | $630.96 |
UPMC Health Plan Setting Facility Modifier None Typical Low $288.40 Median $380.19 Typical High $407.38 | Facility | None | $288.40 | $380.19 | $407.38 |
UPMC Health Plan Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $338.84 | Professional | None | $288.40 | $295.12 | $338.84 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $363.08 | Professional | None | $302.00 | $338.84 | $363.08 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | JW · Drug discarded | $537.03 | $537.03 | $537.03 |
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· 29th of 51
$331
AK $407VT $331
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.