How much rates vary
Facilitymedian $30 · 10th to 90th $25 to $89Professionalmedian $25 · 10th to 90th $22 to $28
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 $24.55 Median $36.31 Typical High $83.18 | Facility | None | $24.55 | $36.31 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | None | $24.55 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.01 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
AmeriHealth Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Capital Blue Cross Setting Facility Modifier None Typical Low $22.91 Median $26.30 Typical High $30.90 | Facility | None | $22.91 | $26.30 | $30.90 |
Capital Blue Cross Setting Professional Modifier None Typical Low $22.39 Median $25.12 Typical High $25.12 | Professional | None | $22.39 | $25.12 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $40.74 Typical High $93.33 | Facility | None | $24.55 | $40.74 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Emblem Health Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $75.86 | Professional | None | $18.62 | $21.88 | $75.86 |
Geisinger Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Geisinger Setting Professional Modifier None Typical Low $25.12 Median $42.66 Typical High $74.13 | Professional | None | $25.12 | $42.66 | $74.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $48.98 Median $67.61 Typical High $138.04 | Facility | None | $48.98 | $67.61 | $138.04 |
Highmark BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $32.36 | Professional | None | $27.54 | $27.54 | $32.36 |
Independence Blue Cross Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Martin's Point Setting Facility Modifier None Typical Low $24.55 Median $36.31 Typical High $63.10 | Facility | None | $24.55 | $36.31 | $63.10 |
Martin's Point Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.01 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.01 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Oscar Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $89.13 | Professional | None | $30.20 | $30.20 | $89.13 |
UPMC Health Plan Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $37.15 | Facility | None | $28.18 | $28.18 | $37.15 |
UPMC Health Plan Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $37.15 | Professional | None | $31.62 | $32.36 | $37.15 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $21.88 Median $25.12 Typical High $30.20 | Professional | None | $21.88 | $25.12 | $30.20 |
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 $23.99 Median $24.55 Typical High $24.55 | Professional | JZ · No drug discarded | $23.99 | $24.55 | $24.55 |
Where Pennsylvania sits
The same service costs 2.8 times more in Wyoming than in North Carolina. 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· 41st of 51
$24.55
WY $61.66NC $22.39
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.