How much rates vary
Facilitymedian $35 · 10th to 90th $31 to $91Professionalmedian $31 · 10th to 90th $31 to $39
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 $30.90 Median $40.74 Typical High $63.10 | Facility | None | $30.90 | $40.74 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $33.88 | Professional | None | $30.90 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.57 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Capital Blue Cross Setting Facility Modifier None Typical Low $28.84 Median $33.11 Typical High $38.90 | Facility | None | $28.84 | $33.11 | $38.90 |
Capital Blue Cross Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | None | $31.62 | $31.62 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $51.29 Typical High $117.49 | Facility | None | $30.90 | $51.29 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Geisinger Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Geisinger Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | None | $46.77 | $46.77 | $54.95 |
Highmark BCBS Setting Facility Modifier None Typical Low $25.70 Median $31.62 Typical High $114.82 | Facility | None | $25.70 | $31.62 | $114.82 |
Martin's Point Setting Facility Modifier None Typical Low $30.90 Median $40.74 Typical High $63.10 | Facility | None | $30.90 | $40.74 | $63.10 |
Martin's Point Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $33.88 | Professional | None | $30.90 | $30.90 | $33.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.57 | $4.68 | $4.68 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
UPMC Health Plan Setting Facility Modifier None Typical Low $33.88 Median $35.48 Typical High $38.90 | Facility | None | $33.88 | $35.48 | $38.90 |
UPMC Health Plan Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $38.90 | Professional | None | $33.88 | $33.88 | $38.90 |
United Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $51.29 | Professional | None | $36.31 | $36.31 | $51.29 |
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 $25.12 Median $46.77 Typical High $104.71 | Facility | JZ · No drug discarded | $25.12 | $46.77 | $104.71 |
Where Pennsylvania sits
The same service costs 1.9 times more in Texas than in Tennessee. 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· 33rd of 51
$33.11
TX $57.54TN $30.90
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.