How much rates vary
Facilitymedian $12 · 10th to 90th $4 to $34Professionalmedian $4 · 10th to 90th $3 to $8
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 $4.07 Median $7.76 Typical High $27.54 | Facility | None | $4.07 | $7.76 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $4.27 Typical High $7.08 | Professional | None | $3.89 | $4.27 | $7.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.04 Typical High $2.24 | Professional | 52 · Reduced service | $2.00 | $2.04 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.81 Typical High $0.89 | Professional | 53 · Discontinued | $0.79 | $0.81 | $0.89 |
Ambetter Setting Professional Modifier None Typical Low $3.09 Median $5.01 Typical High $5.01 | Professional | None | $3.09 | $5.01 | $5.01 |
AmeriHealth Setting Facility Modifier None Typical Low $7.59 Median $20.89 Typical High $331.13 | Facility | None | $7.59 | $20.89 | $331.13 |
AmeriHealth Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Capital Blue Cross Setting Facility Modifier None Typical Low $28.84 Median $37.15 Typical High $5,011.87 | Facility | None | $28.84 | $37.15 | $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 $3.55 Median $7.59 Typical High $15.14 | Facility | None | $3.55 | $7.59 | $15.14 |
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 $5.01 Median $5.01 Typical High $9.77 | Facility | None | $5.01 | $5.01 | $9.77 |
Geisinger Setting Professional Modifier None Typical Low $4.27 Median $5.62 Typical High $7.59 | Professional | None | $4.27 | $5.62 | $7.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $7.59 Median $13.49 Typical High $31.62 | Facility | None | $7.59 | $13.49 | $31.62 |
Highmark BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.80 Typical High $4.79 | Professional | None | $3.02 | $3.80 | $4.79 |
Independence Blue Cross Setting Facility Modifier None Typical Low $6.92 Median $18.62 Typical High $39.81 | Facility | None | $6.92 | $18.62 | $39.81 |
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 $4.07 Median $8.71 Typical High $29.51 | Facility | None | $4.07 | $8.71 | $29.51 |
Martin's Point Setting Professional Modifier None Typical Low $4.07 Median $4.27 Typical High $7.59 | Professional | None | $4.07 | $4.27 | $7.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2.04 Median $2.04 Typical High $2.14 | Professional | 52 · Reduced service | $2.04 | $2.04 | $2.14 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.81 Typical High $0.85 | Professional | 53 · Discontinued | $0.81 | $0.81 | $0.85 |
UPMC Health Plan Setting Facility Modifier None Typical Low $5.01 Median $15.14 Typical High $31.62 | Facility | None | $5.01 | $15.14 | $31.62 |
UPMC Health Plan Setting Professional Modifier None Typical Low $4.47 Median $5.01 Typical High $7.08 | Professional | None | $4.47 | $5.01 | $7.08 |
United Setting Facility Modifier None Typical Low $1.58 Median $5.01 Typical High $6.03 | Facility | None | $1.58 | $5.01 | $6.03 |
United Setting Professional Modifier None Typical Low $2.09 Median $3.24 Typical High $8.71 | Professional | None | $2.09 | $3.24 | $8.71 |
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 $2.40 Median $10.47 Typical High $36.31 | Facility | PN · Off-campus dept, non-excepted | $2.40 | $10.47 | $36.31 |
Where Pennsylvania sits
The same service costs 8.9 times more in Vermont than in Maryland. 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
$6.61
VT $33.88MD $3.80
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.