How much rates vary
Facilitymedian $40 · 10th to 90th $13 to $89Professionalmedian $13 · 10th to 90th $9 to $23
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 $12.30 Median $30.90 Typical High $70.79 | Facility | None | $12.30 | $30.90 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $12.88 Typical High $20.89 | Professional | None | $11.75 | $12.88 | $20.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.03 Median $6.17 Typical High $6.76 | Professional | 52 · Reduced service | $6.03 | $6.17 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.45 Typical High $2.69 | Professional | 53 · Discontinued | $2.40 | $2.45 | $2.69 |
Ambetter Setting Professional Modifier None Typical Low $3.02 Median $9.33 Typical High $15.14 | Professional | None | $3.02 | $9.33 | $15.14 |
AmeriHealth Setting Facility Modifier None Typical Low $29.51 Median $72.44 Typical High $588.84 | Facility | None | $29.51 | $72.44 | $588.84 |
AmeriHealth Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $10.23 | Professional | None | $9.77 | $9.77 | $10.23 |
Capital Blue Cross Setting Facility Modifier None Typical Low $87.10 Median $112.20 Typical High $5,011.87 | Facility | None | $87.10 | $112.20 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $14.79 | Professional | None | $11.75 | $11.75 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $10.47 Median $22.91 Typical High $45.71 | Facility | None | $10.47 | $22.91 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $17.38 Typical High $36.31 | Professional | None | $9.55 | $17.38 | $36.31 |
Emblem Health Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $21.88 | Professional | None | $7.08 | $7.08 | $21.88 |
Geisinger Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Geisinger Setting Professional Modifier None Typical Low $12.88 Median $16.98 Typical High $22.39 | Professional | None | $12.88 | $16.98 | $22.39 |
Highmark BCBS Setting Facility Modifier None Typical Low $23.44 Median $42.66 Typical High $83.18 | Facility | None | $23.44 | $42.66 | $83.18 |
Highmark BCBS Setting Professional Modifier None Typical Low $9.12 Median $11.22 Typical High $25.12 | Professional | None | $9.12 | $11.22 | $25.12 |
Independence Blue Cross Setting Facility Modifier None Typical Low $21.88 Median $66.07 Typical High $588.84 | Facility | None | $21.88 | $66.07 | $588.84 |
Independence Blue Cross Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $10.23 | Professional | None | $9.77 | $9.77 | $10.23 |
Martin's Point Setting Facility Modifier None Typical Low $12.30 Median $34.67 Typical High $74.13 | Facility | None | $12.30 | $34.67 | $74.13 |
Martin's Point Setting Professional Modifier None Typical Low $12.02 Median $12.88 Typical High $22.39 | Professional | None | $12.02 | $12.88 | $22.39 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.17 Median $6.17 Typical High $6.46 | Professional | 52 · Reduced service | $6.17 | $6.17 | $6.46 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $2.57 | Professional | 53 · Discontinued | $2.45 | $2.45 | $2.57 |
UPMC Health Plan Setting Facility Modifier None Typical Low $15.14 Median $39.81 Typical High $83.18 | Facility | None | $15.14 | $39.81 | $83.18 |
UPMC Health Plan Setting Professional Modifier None Typical Low $13.18 Median $15.14 Typical High $21.38 | Professional | None | $13.18 | $15.14 | $21.38 |
United Setting Facility Modifier None Typical Low $13.49 Median $15.14 Typical High $18.20 | Facility | None | $13.49 | $15.14 | $18.20 |
United Setting Professional Modifier None Typical Low $6.31 Median $9.77 Typical High $26.30 | Professional | None | $6.31 | $9.77 | $26.30 |
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 $20.42 Median $43.65 Typical High $102.33 | Facility | PN · Off-campus dept, non-excepted | $20.42 | $43.65 | $102.33 |
Where Pennsylvania sits
The same service costs 7.4 times more in Vermont than in Illinois. 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· 15th of 51
$20.42
VT $85.11IL $11.48
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.