How much rates vary
Facilitymedian $39 · 10th to 90th $14 to $107Professionalmedian $14 · 10th to 90th $10 to $25
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 $13.18 Median $28.84 Typical High $74.13 | Facility | None | $13.18 | $28.84 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $13.80 Typical High $21.38 | Professional | None | $12.59 | $13.80 | $21.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.46 Median $6.61 Typical High $7.24 | Professional | 52 · Reduced service | $6.46 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.63 Typical High $2.95 | Professional | 53 · Discontinued | $2.57 | $2.63 | $2.95 |
Ambetter Setting Professional Modifier None Typical Low $9.77 Median $10.00 Typical High $26.30 | Professional | None | $9.77 | $10.00 | $26.30 |
AmeriHealth Setting Facility Modifier None Typical Low $36.31 Median $6,025.60 Typical High $10,232.93 | Facility | None | $36.31 | $6,025.60 | $10,232.93 |
AmeriHealth Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Capital Blue Cross Setting Facility Modifier None Typical Low $93.33 Median $120.23 Typical High $5,011.87 | Facility | None | $93.33 | $120.23 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $16.22 | Professional | None | $12.59 | $12.59 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $24.55 Typical High $48.98 | Facility | None | $11.48 | $24.55 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $18.20 Typical High $39.81 | Professional | None | $10.23 | $18.20 | $39.81 |
Emblem Health Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $23.44 | Professional | None | $7.59 | $7.59 | $23.44 |
Geisinger Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Geisinger Setting Professional Modifier None Typical Low $13.80 Median $18.20 Typical High $24.55 | Professional | None | $13.80 | $18.20 | $24.55 |
Highmark BCBS Setting Facility Modifier None Typical Low $23.44 Median $45.71 Typical High $100.00 | Facility | None | $23.44 | $45.71 | $100.00 |
Highmark BCBS Setting Professional Modifier None Typical Low $10.72 Median $12.30 Typical High $15.85 | Professional | None | $10.72 | $12.30 | $15.85 |
Independence Blue Cross Setting Facility Modifier None Typical Low $16.22 Median $85.11 Typical High $8,317.64 | Facility | None | $16.22 | $85.11 | $8,317.64 |
Independence Blue Cross Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Martin's Point Setting Facility Modifier None Typical Low $13.18 Median $34.67 Typical High $75.86 | Facility | None | $13.18 | $34.67 | $75.86 |
Martin's Point Setting Professional Modifier None Typical Low $12.88 Median $13.49 Typical High $21.38 | Professional | None | $12.88 | $13.49 | $21.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.61 Median $6.61 Typical High $6.92 | Professional | 52 · Reduced service | $6.61 | $6.61 | $6.92 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $2.75 | Professional | 53 · Discontinued | $2.63 | $2.63 | $2.75 |
UPMC Health Plan Setting Facility Modifier None Typical Low $16.22 Median $51.29 Typical High $107.15 | Facility | None | $16.22 | $51.29 | $107.15 |
UPMC Health Plan Setting Professional Modifier None Typical Low $14.45 Median $16.22 Typical High $23.44 | Professional | None | $14.45 | $16.22 | $23.44 |
United Setting Facility Modifier None Typical Low $14.79 Median $19.50 Typical High $104.71 | Facility | None | $14.79 | $19.50 | $104.71 |
United Setting Professional Modifier None Typical Low $7.41 Median $12.02 Typical High $28.18 | Professional | None | $7.41 | $12.02 | $28.18 |
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 $7.76 Median $38.02 Typical High $102.33 | Facility | PN · Off-campus dept, non-excepted | $7.76 | $38.02 | $102.33 |
Where Pennsylvania sits
The same service costs 8.5 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· 18th of 51
$19.50
VT $105MD $12.30
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.