How much rates vary
Facilitymedian $20 · 10th to 90th $7 to $56Professionalmedian $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 $6.61 Median $12.59 Typical High $42.66 | Facility | None | $6.61 | $12.59 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $6.92 Typical High $11.22 | Professional | None | $6.31 | $6.92 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.24 Median $3.31 Typical High $3.63 | Professional | 52 · Reduced service | $3.24 | $3.31 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.32 Typical High $1.45 | Professional | 53 · Discontinued | $1.29 | $1.32 | $1.45 |
Ambetter Setting Professional Modifier None Typical Low $5.01 Median $8.13 Typical High $8.13 | Professional | None | $5.01 | $8.13 | $8.13 |
AmeriHealth Setting Facility Modifier None Typical Low $14.13 Median $35.48 Typical High $1,023.29 | Facility | None | $14.13 | $35.48 | $1,023.29 |
AmeriHealth Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.50 | Professional | None | $5.37 | $5.37 | $5.50 |
Capital Blue Cross Setting Facility Modifier None Typical Low $46.77 Median $60.26 Typical High $5,011.87 | Facility | None | $46.77 | $60.26 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $19.05 | Professional | None | $6.31 | $6.31 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $12.30 Typical High $24.55 | Facility | None | $5.75 | $12.30 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $9.12 Typical High $19.95 | Professional | None | $5.13 | $9.12 | $19.95 |
Emblem Health Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $11.75 | Professional | None | $3.80 | $3.80 | $11.75 |
Geisinger Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Geisinger Setting Professional Modifier None Typical Low $6.92 Median $9.12 Typical High $12.30 | Professional | None | $6.92 | $9.12 | $12.30 |
Highmark BCBS Setting Facility Modifier None Typical Low $12.59 Median $22.91 Typical High $70.79 | Facility | None | $12.59 | $22.91 | $70.79 |
Highmark BCBS Setting Professional Modifier None Typical Low $4.90 Median $6.17 Typical High $11.48 | Professional | None | $4.90 | $6.17 | $11.48 |
Independence Blue Cross Setting Facility Modifier None Typical Low $13.18 Median $32.36 Typical High $1,023.29 | Facility | None | $13.18 | $32.36 | $1,023.29 |
Independence Blue Cross Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.50 | Professional | None | $5.37 | $5.37 | $5.50 |
Martin's Point Setting Facility Modifier None Typical Low $6.61 Median $12.88 Typical High $45.71 | Facility | None | $6.61 | $12.88 | $45.71 |
Martin's Point Setting Professional Modifier None Typical Low $6.61 Median $6.92 Typical High $11.22 | Professional | None | $6.61 | $6.92 | $11.22 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $3.31 Median $3.31 Typical High $3.47 | Professional | 52 · Reduced service | $3.31 | $3.31 | $3.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.32 Typical High $1.38 | Professional | 53 · Discontinued | $1.32 | $1.32 | $1.38 |
UPMC Health Plan Setting Facility Modifier None Typical Low $8.13 Median $28.18 Typical High $58.88 | Facility | None | $8.13 | $28.18 | $58.88 |
UPMC Health Plan Setting Professional Modifier None Typical Low $7.24 Median $8.13 Typical High $11.75 | Professional | None | $7.24 | $8.13 | $11.75 |
United Setting Facility Modifier None Typical Low $2.75 Median $8.13 Typical High $9.77 | Facility | None | $2.75 | $8.13 | $9.77 |
United Setting Professional Modifier None Typical Low $3.47 Median $5.25 Typical High $14.13 | Professional | None | $3.47 | $5.25 | $14.13 |
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 $3.89 Median $19.95 Typical High $93.33 | Facility | PN · Off-campus dept, non-excepted | $3.89 | $19.95 | $93.33 |
Where Pennsylvania sits
The same service costs 17.0 times more in Vermont than in Kentucky. 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
$10.72
VT $100KY $5.89
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.