How much rates vary
Facilitymedian $11 · 10th to 90th $4 to $34Professionalmedian $4 · 10th to 90th $3 to $7
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 $3.98 Median $7.08 Typical High $15.85 | Facility | None | $3.98 | $7.08 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $4.17 Typical High $6.61 | Professional | None | $3.89 | $4.17 | $6.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.95 Median $2.00 Typical High $2.24 | Professional | 52 · Reduced service | $1.95 | $2.00 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.79 Typical High $0.89 | Professional | 53 · Discontinued | $0.78 | $0.79 | $0.89 |
Ambetter Setting Professional Modifier None Typical Low $3.02 Median $4.90 Typical High $4.90 | Professional | None | $3.02 | $4.90 | $4.90 |
AmeriHealth Setting Facility Modifier None Typical Low $2.45 Median $323.59 Typical High $549.54 | Facility | None | $2.45 | $323.59 | $549.54 |
AmeriHealth Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $8.13 | Professional | None | $3.24 | $3.24 | $8.13 |
Capital Blue Cross Setting Facility Modifier None Typical Low $28.18 Median $36.31 Typical High $5,011.87 | Facility | None | $28.18 | $36.31 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $11.22 | Professional | None | $3.89 | $3.89 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $3.47 Median $7.59 Typical High $14.79 | Facility | None | $3.47 | $7.59 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $5.13 Typical High $12.02 | Professional | None | $3.09 | $5.13 | $12.02 |
Emblem Health Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $7.24 | Professional | None | $2.34 | $2.34 | $7.24 |
Geisinger Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
Geisinger Setting Professional Modifier None Typical Low $4.17 Median $5.50 Typical High $7.41 | Professional | None | $4.17 | $5.50 | $7.41 |
Highmark BCBS Setting Facility Modifier None Typical Low $6.92 Median $14.13 Typical High $28.18 | Facility | None | $6.92 | $14.13 | $28.18 |
Highmark BCBS Setting Professional Modifier None Typical Low $2.95 Median $3.72 Typical High $4.07 | Professional | None | $2.95 | $3.72 | $4.07 |
Independence Blue Cross Setting Facility Modifier None Typical Low $3.47 Median $4.90 Typical High $416.87 | Facility | None | $3.47 | $4.90 | $416.87 |
Independence Blue Cross Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Martin's Point Setting Facility Modifier None Typical Low $3.98 Median $8.51 Typical High $17.78 | Facility | None | $3.98 | $8.51 | $17.78 |
Martin's Point Setting Professional Modifier None Typical Low $3.98 Median $4.17 Typical High $6.61 | Professional | None | $3.98 | $4.17 | $6.61 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.00 Typical High $2.09 | Professional | 52 · Reduced service | $2.00 | $2.00 | $2.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.79 Typical High $0.83 | Professional | 53 · Discontinued | $0.79 | $0.79 | $0.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $11.48 Median $21.88 Typical High $38.90 | Facility | None | $11.48 | $21.88 | $38.90 |
UPMC Health Plan Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
United Setting Facility Modifier None Typical Low $1.38 Median $4.90 Typical High $10.47 | Facility | None | $1.38 | $4.90 | $10.47 |
United Setting Professional Modifier None Typical Low $2.09 Median $3.24 Typical High $8.71 | Professional | None | $2.09 | $3.24 | $8.71 |
2 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier XU · Unusual separate service Typical Low $10.00 Median $17.78 Typical High $32.36 | Facility | XU · Unusual separate service | $10.00 | $17.78 | $32.36 |
UPMC Health Plan Setting Professional Modifier QW · Waived lab test Typical Low $4.37 Median $4.90 Typical High $6.17 | Professional | QW · Waived lab test | $4.37 | $4.90 | $6.17 |
Where Pennsylvania sits
The same service costs 9.3 times more in Vermont than in Georgia. 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· 25th of 51
$5.37
VT $33.88GA $3.63
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.