How much rates vary
Facilitymedian $58 · 10th to 90th $48 to $141Professionalmedian $52 · 10th to 90th $48 to $59
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 $52.48 Median $81.28 Typical High $141.25 | Facility | None | $52.48 | $81.28 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | None | $52.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.30 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
AmeriHealth Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $54.95 | Facility | None | $47.86 | $47.86 | $54.95 |
Capital Blue Cross Setting Facility Modifier None Typical Low $50.12 Median $57.54 Typical High $67.61 | Facility | None | $50.12 | $57.54 | $67.61 |
Capital Blue Cross Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $79.43 Typical High $181.97 | Facility | None | $47.86 | $79.43 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Geisinger Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Geisinger Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | None | $79.43 | $79.43 | $95.50 |
Highmark BCBS Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $104.71 | Facility | None | $56.23 | $56.23 | $104.71 |
Independence Blue Cross Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $57.54 | Facility | None | $47.86 | $47.86 | $57.54 |
Martin's Point Setting Facility Modifier None Typical Low $52.48 Median $81.28 Typical High $141.25 | Facility | None | $52.48 | $81.28 | $141.25 |
Martin's Point Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | None | $52.48 | $53.70 | $53.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.30 | $26.92 | $26.92 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $7.94 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
UPMC Health Plan Setting Facility Modifier None Typical Low $52.48 Median $61.66 Typical High $64.57 | Facility | None | $52.48 | $61.66 | $64.57 |
UPMC Health Plan Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $61.66 | Professional | None | $52.48 | $52.48 | $61.66 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $74.13 | Professional | None | $52.48 | $52.48 | $74.13 |
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 $57.54 Median $117.49 Typical High $257.04 | Facility | JZ · No drug discarded | $57.54 | $117.49 | $257.04 |
Where Pennsylvania sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 22nd of 51
$53.70
AZ $83.18RI $47.86
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.