How much rates vary
Facilitymedian $15 · 10th to 90th $5 to $47Professionalmedian $5 · 10th to 90th $3 to $9
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 $4.68 Median $9.77 Typical High $43.65 | Facility | None | $4.68 | $9.77 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $4.90 Typical High $7.94 | Professional | None | $4.57 | $4.90 | $7.94 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.29 Median $2.34 Typical High $2.57 | Professional | 52 · Reduced service | $2.29 | $2.34 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $0.93 Typical High $1.05 | Professional | 53 · Discontinued | $0.91 | $0.93 | $1.05 |
Ambetter Setting Professional Modifier None Typical Low $3.47 Median $5.75 Typical High $9.33 | Professional | None | $3.47 | $5.75 | $9.33 |
AmeriHealth Setting Facility Modifier None Typical Low $9.55 Median $27.54 Typical High $1,288.25 | Facility | None | $9.55 | $27.54 | $1,288.25 |
AmeriHealth Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.89 | Professional | None | $3.80 | $3.80 | $3.89 |
Capital Blue Cross Setting Facility Modifier None Typical Low $33.11 Median $42.66 Typical High $5,011.87 | Facility | None | $33.11 | $42.66 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.75 | Professional | None | $4.47 | $4.47 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $8.91 Typical High $17.38 | Facility | None | $4.07 | $8.91 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $6.03 Typical High $13.80 | Professional | None | $3.55 | $6.03 | $13.80 |
Emblem Health Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $8.32 | Professional | None | $2.69 | $2.69 | $8.32 |
Geisinger Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Geisinger Setting Professional Modifier None Typical Low $4.90 Median $6.46 Typical High $8.71 | Professional | None | $4.90 | $6.46 | $8.71 |
Highmark BCBS Setting Facility Modifier None Typical Low $8.71 Median $17.38 Typical High $39.81 | Facility | None | $8.71 | $17.38 | $39.81 |
Highmark BCBS Setting Professional Modifier None Typical Low $3.47 Median $4.37 Typical High $9.77 | Professional | None | $3.47 | $4.37 | $9.77 |
Independence Blue Cross Setting Facility Modifier None Typical Low $8.13 Median $24.55 Typical High $51.29 | Facility | None | $8.13 | $24.55 | $51.29 |
Independence Blue Cross Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.89 | Professional | None | $3.80 | $3.80 | $3.89 |
Martin's Point Setting Facility Modifier None Typical Low $4.68 Median $10.96 Typical High $53.70 | Facility | None | $4.68 | $10.96 | $53.70 |
Martin's Point Setting Professional Modifier None Typical Low $4.57 Median $4.90 Typical High $8.71 | Professional | None | $4.57 | $4.90 | $8.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2.34 Median $2.34 Typical High $2.45 | Professional | 52 · Reduced service | $2.34 | $2.34 | $2.45 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $0.93 Typical High $0.98 | Professional | 53 · Discontinued | $0.93 | $0.93 | $0.98 |
UPMC Health Plan Setting Facility Modifier None Typical Low $13.49 Median $24.55 Typical High $43.65 | Facility | None | $13.49 | $24.55 | $43.65 |
UPMC Health Plan Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
United Setting Facility Modifier None Typical Low $5.25 Median $5.75 Typical High $6.92 | Facility | None | $5.25 | $5.75 | $6.92 |
United Setting Professional Modifier None Typical Low $2.57 Median $4.27 Typical High $10.00 | Professional | None | $2.57 | $4.27 | $10.00 |
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 $4.68 Median $14.13 Typical High $48.98 | Facility | PN · Off-campus dept, non-excepted | $4.68 | $14.13 | $48.98 |
Where Pennsylvania sits
The same service costs 12.9 times more in Vermont than in Alabama. 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· 14th of 51
$7.94
VT $51.29AL $3.98
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.