How much rates vary
Facilitymedian $38 · 10th to 90th $33 to $98Professionalmedian $33 · 10th to 90th $30 to $34
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 $28.18 Median $40.74 Typical High $83.18 | Facility | None | $28.18 | $40.74 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.88 | Professional | None | $33.11 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.01 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.31 |
Capital Blue Cross Setting Facility Modifier None Typical Low $30.90 Median $35.48 Typical High $42.66 | Facility | None | $30.90 | $35.48 | $42.66 |
Capital Blue Cross Setting Professional Modifier None Typical Low $30.90 Median $33.88 Typical High $33.88 | Professional | None | $30.90 | $33.88 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $54.95 Typical High $125.89 | Facility | None | $33.11 | $54.95 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Emblem Health Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $47.86 | Professional | None | $33.11 | $33.11 | $47.86 |
Geisinger Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Geisinger Setting Professional Modifier None Typical Low $23.99 Median $34.67 Typical High $56.23 | Professional | None | $23.99 | $34.67 | $56.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $64.57 Median $83.18 Typical High $112.20 | Facility | None | $64.57 | $83.18 | $112.20 |
Highmark BCBS Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $37.15 | Professional | None | $32.36 | $33.88 | $37.15 |
Martin's Point Setting Facility Modifier None Typical Low $33.11 Median $47.86 Typical High $83.18 | Facility | None | $33.11 | $47.86 | $83.18 |
Martin's Point Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.60 | $16.60 | $16.60 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.01 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.01 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.31 |
Oscar Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $54.95 | Professional | None | $30.20 | $30.20 | $54.95 |
UPMC Health Plan Setting Facility Modifier None Typical Low $25.70 Median $38.02 Typical High $40.74 | Facility | None | $25.70 | $38.02 | $40.74 |
UPMC Health Plan Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $29.51 | Professional | None | $25.70 | $26.30 | $29.51 |
United Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $28.84 Median $33.11 Typical High $34.67 | Professional | None | $28.84 | $33.11 | $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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $26.30 Median $31.62 Typical High $33.11 | Professional | JZ · No drug discarded | $26.30 | $31.62 | $33.11 |
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· 34th of 51
$33.11
AK $41.69AZ $33.11
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.