How much rates vary
Facilitymedian $78 · 10th to 90th $68 to $257Professionalmedian $68 · 10th to 90th $68 to $138
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 $67.61 Median $102.33 Typical High $416.87 | Facility | None | $67.61 | $102.33 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $102.33 | Professional | None | $67.61 | $67.61 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Capital Blue Cross Setting Facility Modifier None Typical Low $63.10 Median $70.79 Typical High $85.11 | Facility | None | $63.10 | $70.79 | $85.11 |
Capital Blue Cross Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $112.20 Typical High $257.04 | Facility | None | $67.61 | $112.20 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Geisinger Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Geisinger Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | None | $100.00 | $100.00 | $120.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $66.07 Median $190.55 Typical High $229.09 | Facility | None | $66.07 | $190.55 | $229.09 |
Martin's Point Setting Facility Modifier None Typical Low $67.61 Median $102.33 Typical High $263.03 | Facility | None | $67.61 | $102.33 | $263.03 |
Martin's Point Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $102.33 | Professional | None | $67.61 | $67.61 | $102.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
UPMC Health Plan Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $158.49 | Facility | None | $77.62 | $77.62 | $158.49 |
UPMC Health Plan Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | None | $138.04 | $138.04 | $158.49 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $144.54 | Professional | None | $79.43 | $85.11 | $144.54 |
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 $102.33 Median $316.23 Typical High $489.78 | Facility | JZ · No drug discarded | $102.33 | $316.23 | $489.78 |
Where Pennsylvania sits
The same service costs 2.7 times more in South Carolina than in Georgia. 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· 44th of 51
$75.86
SC $182GA $67.61
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.