How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $1
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 $0.36 Median $0.56 Typical High $2.14 | Facility | None | $0.36 | $0.56 | $2.14 |
Aetna Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.56 | Professional | None | $0.37 | $0.37 | $0.56 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 52 · Reduced service | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Capital Blue Cross Setting Facility Modifier None Typical Low $0.35 Median $0.40 Typical High $0.48 | Facility | None | $0.35 | $0.40 | $0.48 |
Capital Blue Cross Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | None | $0.38 | $0.38 | $0.38 |
Cigna Setting Facility Modifier None Typical Low $0.37 Median $0.62 Typical High $1.41 | Facility | None | $0.37 | $0.62 | $1.41 |
Cigna Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | None | $0.37 | $0.37 | $0.37 |
Geisinger Setting Facility Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Facility | None | $0.37 | $0.37 | $0.37 |
Geisinger Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.68 | Professional | None | $0.56 | $0.56 | $0.68 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.56 Median $0.69 Typical High $2.14 | Facility | None | $0.56 | $0.69 | $2.14 |
Independence Blue Cross Setting Facility Modifier None Typical Low $0.25 Median $0.28 Typical High $0.28 | Facility | None | $0.25 | $0.28 | $0.28 |
Martin's Point Setting Facility Modifier None Typical Low $0.36 Median $0.56 Typical High $0.95 | Facility | None | $0.36 | $0.56 | $0.95 |
Martin's Point Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.56 | Professional | None | $0.37 | $0.37 | $0.56 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 52 · Reduced service | $0.19 | $0.19 | $0.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
UPMC Health Plan Setting Facility Modifier None Typical Low $0.43 Median $0.43 Typical High $0.65 | Facility | None | $0.43 | $0.43 | $0.65 |
UPMC Health Plan Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.65 | Professional | None | $0.56 | $0.56 | $0.65 |
United Setting Facility Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Facility | None | $0.37 | $0.37 | $0.37 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.42 | Professional | None | $0.23 | $0.23 | $0.42 |
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 $0.31 Median $0.83 Typical High $1.74 | Facility | JZ · No drug discarded | $0.31 | $0.83 | $1.74 |
Where Pennsylvania sits
The same service costs 7.8 times more in Texas than in Maryland. 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· 25th of 51
$0.37
TX $1.78MD $0.23
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.