How much rates vary
Facilitymedian $5 · 10th to 90th $2 to $17Professionalmedian $2 · 10th to 90th $1 to $4
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 $1.82 Median $2.88 Typical High $6.76 | Facility | None | $1.82 | $2.88 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $1.82 Median $1.91 Typical High $3.47 | Professional | None | $1.82 | $1.91 | $3.47 |
Ambetter Setting Professional Modifier None Typical Low $1.38 Median $2.24 Typical High $3.63 | Professional | None | $1.38 | $2.24 | $3.63 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $1.12 Median $1.95 Typical High $4.47 | Professional | QW · Waived lab test | $1.12 | $1.95 | $4.47 |
AmeriHealth Setting Facility Modifier None Typical Low $4.27 Median $10.47 Typical High $478.63 | Facility | None | $4.27 | $10.47 | $478.63 |
AmeriHealth Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.51 | Professional | None | $1.45 | $1.45 | $1.51 |
Capital Blue Cross Setting Facility Modifier None Typical Low $12.88 Median $16.60 Typical High $5,011.87 | Facility | None | $12.88 | $16.60 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $5.01 | Professional | None | $1.78 | $1.78 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $1.58 Median $3.47 Typical High $6.76 | Facility | None | $1.58 | $3.47 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $2.24 Typical High $4.79 | Professional | None | $1.41 | $2.24 | $4.79 |
Emblem Health Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $3.24 | Professional | None | $1.07 | $1.07 | $3.24 |
Geisinger Setting Facility Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Facility | None | $2.24 | $2.24 | $2.24 |
Geisinger Setting Professional Modifier None Typical Low $1.91 Median $2.51 Typical High $3.39 | Professional | None | $1.91 | $2.51 | $3.39 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.39 Median $6.61 Typical High $17.78 | Facility | None | $3.39 | $6.61 | $17.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $1.74 Median $2.19 Typical High $4.57 | Professional | None | $1.74 | $2.19 | $4.57 |
Independence Blue Cross Setting Facility Modifier None Typical Low $3.16 Median $9.55 Typical High $208.93 | Facility | None | $3.16 | $9.55 | $208.93 |
Independence Blue Cross Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.51 | Professional | None | $1.45 | $1.45 | $1.51 |
Martin's Point Setting Facility Modifier None Typical Low $1.82 Median $2.88 Typical High $6.76 | Facility | None | $1.82 | $2.88 | $6.76 |
Martin's Point Setting Professional Modifier None Typical Low $1.82 Median $1.91 Typical High $3.47 | Professional | None | $1.82 | $1.91 | $3.47 |
UPMC Health Plan Setting Facility Modifier None Typical Low $5.13 Median $15.49 Typical High $27.54 | Facility | None | $5.13 | $15.49 | $27.54 |
UPMC Health Plan Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
United Setting Facility Modifier None Typical Low $2.04 Median $2.24 Typical High $2.69 | Facility | None | $2.04 | $2.24 | $2.69 |
United Setting Professional Modifier None Typical Low $1.35 Median $2.24 Typical High $3.80 | Professional | None | $1.35 | $2.24 | $3.80 |
5 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 $0.89 Median $0.91 Typical High $1.00 | Professional | 52 · Reduced service | $0.89 | $0.91 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.36 Typical High $0.40 | Professional | 53 · Discontinued | $0.36 | $0.36 | $0.40 |
Highmark BCBS Setting Facility Modifier XU · Unusual separate service Typical Low $3.98 Median $10.72 Typical High $33.11 | Facility | XU · Unusual separate service | $3.98 | $10.72 | $33.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.91 Median $0.91 Typical High $0.95 | Professional | 52 · Reduced service | $0.91 | $0.91 | $0.95 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.36 Typical High $0.38 | Professional | 53 · Discontinued | $0.36 | $0.36 | $0.38 |
Where Pennsylvania sits
The same service costs 20.4 times more in Vermont 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· 18th of 51
$2.82
VT $37.15DC $1.82
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.