How much rates vary
Facilitymedian $35 · 10th to 90th $31 to $112Professionalmedian $31 · 10th to 90th $30 to $32
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 $30.90 Median $54.95 Typical High $81.28 | Facility | None | $30.90 | $54.95 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $4.68 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Capital Blue Cross Setting Facility Modifier None Typical Low $28.84 Median $33.11 Typical High $39.81 | Facility | None | $28.84 | $33.11 | $39.81 |
Capital Blue Cross Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $31.62 | Professional | None | $28.84 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $51.29 Typical High $117.49 | Facility | None | $30.90 | $51.29 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $44.67 | Professional | None | $30.90 | $30.90 | $44.67 |
Geisinger Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Geisinger Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $56.23 | Professional | None | $30.90 | $39.81 | $56.23 |
Independence Blue Cross Setting Facility Modifier None Typical Low $31.62 Median $35.48 Typical High $37.15 | Facility | None | $31.62 | $35.48 | $37.15 |
Martin's Point Setting Facility Modifier None Typical Low $30.90 Median $72.44 Typical High $81.28 | Facility | None | $30.90 | $72.44 | $81.28 |
Martin's Point Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $4.68 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $4.68 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Oscar Health Setting Professional Modifier None Typical Low $0.60 Median $30.20 Typical High $74.13 | Professional | None | $0.60 | $30.20 | $74.13 |
UPMC Health Plan Setting Facility Modifier None Typical Low $32.36 Median $35.48 Typical High $38.02 | Facility | None | $32.36 | $35.48 | $38.02 |
UPMC Health Plan Setting Professional Modifier None Typical Low $32.36 Median $33.11 Typical High $37.15 | Professional | None | $32.36 | $33.11 | $37.15 |
United Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $29.51 Median $32.36 Typical High $34.67 | Professional | None | $29.51 | $32.36 | $34.67 |
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 JW · Drug discarded Typical Low $58.88 Median $58.88 Typical High $61.66 | Facility | JW · Drug discarded | $58.88 | $58.88 | $61.66 |
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· 30th of 51
$30.90
AK $38.90CA $30.90
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.