How much rates vary
Facilitymedian $8 · 10th to 90th $3 to $28Professionalmedian $3 · 10th to 90th $2 to $5
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 $2.57 Median $6.61 Typical High $28.18 | Facility | None | $2.57 | $6.61 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.69 Typical High $4.90 | Professional | None | $2.51 | $2.69 | $4.90 |
Ambetter Setting Professional Modifier None Typical Low $1.58 Median $1.95 Typical High $3.16 | Professional | None | $1.58 | $1.95 | $3.16 |
AmeriHealth Setting Facility Modifier None Typical Low $4.79 Median $13.49 Typical High $724.44 | Facility | None | $4.79 | $13.49 | $724.44 |
AmeriHealth Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.14 | Professional | None | $2.04 | $2.04 | $2.14 |
Capital Blue Cross Setting Facility Modifier None Typical Low $18.20 Median $23.44 Typical High $5,011.87 | Facility | None | $18.20 | $23.44 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $7.08 | Professional | None | $2.45 | $2.45 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $2.19 Median $4.90 Typical High $9.55 | Facility | None | $2.19 | $4.90 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $2.04 Median $3.24 Typical High $6.46 | Professional | None | $2.04 | $3.24 | $6.46 |
Emblem Health Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $4.57 | Professional | None | $1.48 | $1.48 | $4.57 |
Geisinger Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
Geisinger Setting Professional Modifier None Typical Low $2.69 Median $3.47 Typical High $4.79 | Professional | None | $2.69 | $3.47 | $4.79 |
Highmark BCBS Setting Facility Modifier None Typical Low $4.90 Median $9.12 Typical High $28.84 | Facility | None | $4.90 | $9.12 | $28.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $1.91 Median $2.40 Typical High $4.47 | Professional | None | $1.91 | $2.40 | $4.47 |
Independence Blue Cross Setting Facility Modifier None Typical Low $4.47 Median $12.02 Typical High $26.92 | Facility | None | $4.47 | $12.02 | $26.92 |
Independence Blue Cross Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.14 | Professional | None | $2.04 | $2.04 | $2.14 |
Martin's Point Setting Facility Modifier None Typical Low $2.57 Median $7.24 Typical High $35.48 | Facility | None | $2.57 | $7.24 | $35.48 |
Martin's Point Setting Professional Modifier None Typical Low $2.57 Median $2.69 Typical High $4.90 | Professional | None | $2.57 | $2.69 | $4.90 |
UPMC Health Plan Setting Facility Modifier None Typical Low $3.16 Median $7.76 Typical High $14.79 | Facility | None | $3.16 | $7.76 | $14.79 |
UPMC Health Plan Setting Professional Modifier None Typical Low $2.82 Median $3.16 Typical High $4.47 | Professional | None | $2.82 | $3.16 | $4.47 |
United Setting Facility Modifier None Typical Low $1.12 Median $3.16 Typical High $3.80 | Facility | None | $1.12 | $3.16 | $3.80 |
United Setting Professional Modifier None Typical Low $1.91 Median $3.16 Typical High $5.37 | Professional | None | $1.91 | $3.16 | $5.37 |
7 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.26 Median $1.29 Typical High $1.41 | Professional | 52 · Reduced service | $1.26 | $1.29 | $1.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.51 Typical High $0.56 | Professional | 53 · Discontinued | $0.50 | $0.51 | $0.56 |
Highmark BCBS Setting Facility Modifier 59 · Distinct service Typical Low $6.03 Median $7.94 Typical High $15.85 | Facility | 59 · Distinct service | $6.03 | $7.94 | $15.85 |
Highmark BCBS Setting Facility Modifier PN · Off-campus dept, non-excepted Typical Low $4.37 Median $9.77 Typical High $36.31 | Facility | PN · Off-campus dept, non-excepted | $4.37 | $9.77 | $36.31 |
Highmark BCBS Setting Facility Modifier XU · Unusual separate service Typical Low $4.90 Median $15.49 Typical High $35.48 | Facility | XU · Unusual separate service | $4.90 | $15.49 | $35.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1.29 Median $1.29 Typical High $1.35 | Professional | 52 · Reduced service | $1.29 | $1.29 | $1.35 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.51 Median $0.51 Typical High $0.54 | Professional | 53 · Discontinued | $0.51 | $0.51 | $0.54 |
Where Pennsylvania sits
The same service costs 22.4 times more in Minnesota than in Washington, DC. 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
$4.37
MN $56.23DC $2.51
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.