How much rates vary
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 $23.44 Median $24.55 Typical High $85.11 | Facility | None | $23.44 | $24.55 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $23.44 Typical High $26.30 | Professional | None | $22.91 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.48 Median $11.75 Typical High $12.88 | Professional | 52 · Reduced service | $11.48 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.68 Typical High $5.13 | Professional | 53 · Discontinued | $4.57 | $4.68 | $5.13 |
Capital Blue Cross Setting Facility Modifier None Typical Low $165.96 Median $213.80 Typical High $5,011.87 | Facility | None | $165.96 | $213.80 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $28.84 | Professional | None | $22.39 | $22.39 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $43.65 Typical High $87.10 | Facility | None | $19.95 | $43.65 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $32.36 Typical High $69.18 | Professional | None | $18.20 | $32.36 | $69.18 |
Emblem Health Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $41.69 | Professional | None | $13.49 | $13.49 | $41.69 |
Geisinger Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Geisinger Setting Professional Modifier None Typical Low $24.55 Median $32.36 Typical High $43.65 | Professional | None | $24.55 | $32.36 | $43.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $112.20 | Facility | None | $97.72 | $97.72 | $112.20 |
Martin's Point Setting Facility Modifier None Typical Low $23.44 Median $24.55 Typical High $85.11 | Facility | None | $23.44 | $24.55 | $85.11 |
Martin's Point Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $26.30 | Professional | None | $23.44 | $23.44 | $26.30 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 52 · Reduced service | $11.75 | $11.75 | $12.30 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $4.90 | Professional | 53 · Discontinued | $4.68 | $4.68 | $4.90 |
UPMC Health Plan Setting Facility Modifier None Typical Low $28.84 Median $123.03 Typical High $257.04 | Facility | None | $28.84 | $123.03 | $257.04 |
UPMC Health Plan Setting Professional Modifier None Typical Low $25.12 Median $28.84 Typical High $40.74 | Professional | None | $25.12 | $28.84 | $40.74 |
United Setting Facility Modifier None Typical Low $25.70 Median $28.84 Typical High $34.67 | Facility | None | $25.70 | $28.84 | $34.67 |
United Setting Professional Modifier None Typical Low $12.88 Median $20.89 Typical High $50.12 | Professional | None | $12.88 | $20.89 | $50.12 |
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 Professional Modifier 90 · Outside lab Typical Low $19.05 Median $19.05 Typical High $23.99 | Professional | 90 · Outside lab | $19.05 | $19.05 | $23.99 |
Where Pennsylvania sits
The same service costs 5.5 times more in Kansas 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· 32nd of 51
$25.12
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.