How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $0
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 $0.26 Median $0.43 Typical High $1.10 | Facility | None | $0.26 | $0.43 | $1.10 |
Aetna Setting Professional Modifier None Typical Low $0.35 Median $0.36 Typical High $0.43 | Professional | None | $0.35 | $0.36 | $0.43 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.18 | $0.18 | $0.18 |
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 $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
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 $0.33 Median $0.38 Typical High $0.45 | Facility | None | $0.33 | $0.38 | $0.45 |
Capital Blue Cross Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
Cigna Setting Facility Modifier None Typical Low $0.35 Median $0.58 Typical High $1.35 | Facility | None | $0.35 | $0.58 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Geisinger Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Facility | None | $0.35 | $0.35 | $0.35 |
Geisinger Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.63 | Professional | None | $0.52 | $0.52 | $0.63 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.81 Median $0.98 Typical High $2.45 | Facility | None | $0.81 | $0.98 | $2.45 |
Martin's Point Setting Facility Modifier None Typical Low $0.26 Median $0.52 Typical High $0.91 | Facility | None | $0.26 | $0.52 | $0.91 |
Martin's Point Setting Professional Modifier None Typical Low $0.35 Median $0.36 Typical High $0.39 | Professional | None | $0.35 | $0.36 | $0.39 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.18 | $0.18 | $0.18 |
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 $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
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 $0.24 Median $0.41 Typical High $0.43 | Facility | None | $0.24 | $0.41 | $0.43 |
UPMC Health Plan Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.28 | Professional | None | $0.24 | $0.24 | $0.28 |
United Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Facility | None | $0.35 | $0.35 | $0.35 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.37 Typical High $0.65 | Professional | None | $0.35 | $0.37 | $0.65 |
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 $0.36 Median $1.07 Typical High $2.24 | Facility | JZ · No drug discarded | $0.36 | $1.07 | $2.24 |
Where Pennsylvania sits
The same service costs 3.0 times more in Texas than in North Dakota. 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· 36th of 51
$0.36
TX $0.98ND $0.33
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.