How much rates vary
Facilitymedian $21 · 10th to 90th $7 to $68Professionalmedian $7 · 10th to 90th $5 to $13
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 $7.08 Median $13.49 Typical High $47.86 | Facility | None | $7.08 | $13.49 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $7.08 Typical High $11.48 | Professional | None | $6.92 | $7.08 | $11.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.47 Median $3.55 Typical High $3.89 | Professional | 52 · Reduced service | $3.47 | $3.55 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.41 Typical High $1.55 | Professional | 53 · Discontinued | $1.38 | $1.41 | $1.55 |
Ambetter Setting Professional Modifier None Typical Low $5.37 Median $8.71 Typical High $8.71 | Professional | None | $5.37 | $8.71 | $8.71 |
AmeriHealth Setting Facility Modifier None Typical Low $13.18 Median $36.31 Typical High $741.31 | Facility | None | $13.18 | $36.31 | $741.31 |
Capital Blue Cross Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $5,011.87 | Facility | None | $50.12 | $64.57 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $19.50 | Professional | None | $6.76 | $6.76 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $6.03 Median $13.18 Typical High $26.30 | Facility | None | $6.03 | $13.18 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $9.12 Typical High $21.38 | Professional | None | $5.50 | $9.12 | $21.38 |
Emblem Health Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $12.59 | Professional | None | $4.07 | $4.07 | $12.59 |
Geisinger Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Geisinger Setting Professional Modifier None Typical Low $7.41 Median $9.77 Typical High $12.88 | Professional | None | $7.41 | $9.77 | $12.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $12.59 Median $24.55 Typical High $74.13 | Facility | None | $12.59 | $24.55 | $74.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $5.25 Median $6.46 Typical High $7.24 | Professional | None | $5.25 | $6.46 | $7.24 |
Independence Blue Cross Setting Facility Modifier None Typical Low $12.02 Median $33.11 Typical High $74.13 | Facility | None | $12.02 | $33.11 | $74.13 |
Martin's Point Setting Facility Modifier None Typical Low $7.08 Median $16.22 Typical High $50.12 | Facility | None | $7.08 | $16.22 | $50.12 |
Martin's Point Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $11.48 | Professional | None | $7.08 | $7.08 | $11.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $3.55 Median $3.55 Typical High $3.72 | Professional | 52 · Reduced service | $3.55 | $3.55 | $3.72 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.41 Typical High $1.48 | Professional | 53 · Discontinued | $1.41 | $1.41 | $1.48 |
UPMC Health Plan Setting Facility Modifier None Typical Low $19.95 Median $46.77 Typical High $83.18 | Facility | None | $19.95 | $46.77 | $83.18 |
UPMC Health Plan Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
United Setting Facility Modifier None Typical Low $7.76 Median $8.71 Typical High $10.47 | Facility | None | $7.76 | $8.71 | $10.47 |
United Setting Professional Modifier None Typical Low $3.63 Median $5.62 Typical High $15.14 | Professional | None | $3.63 | $5.62 | $15.14 |
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 PN · Off-campus dept, non-excepted Typical Low $4.17 Median $26.92 Typical High $100.00 | Facility | PN · Off-campus dept, non-excepted | $4.17 | $26.92 | $100.00 |
Where Pennsylvania sits
The same service costs 10.5 times more in Vermont 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· 15th of 51
$11.48
VT $67.61MD $6.46
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.