How much rates vary
Facilitymedian $37 · 10th to 90th $13 to $89Professionalmedian $13 · 10th to 90th $9 to $22
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 $12.02 Median $27.54 Typical High $52.48 | Facility | None | $12.02 | $27.54 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $12.59 Typical High $20.42 | Professional | None | $11.48 | $12.59 | $20.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.75 Median $6.03 Typical High $6.61 | Professional | 52 · Reduced service | $5.75 | $6.03 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.40 Typical High $2.63 | Professional | 53 · Discontinued | $2.29 | $2.40 | $2.63 |
Ambetter Setting Professional Modifier None Typical Low $8.91 Median $14.79 Typical High $23.44 | Professional | None | $8.91 | $14.79 | $23.44 |
AmeriHealth Setting Facility Modifier None Typical Low $28.18 Median $70.79 Typical High $416.87 | Facility | None | $28.18 | $70.79 | $416.87 |
AmeriHealth Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $10.00 | Professional | None | $9.55 | $9.55 | $10.00 |
Capital Blue Cross Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $5,011.87 | Facility | None | $85.11 | $109.65 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $14.45 | Professional | None | $11.48 | $11.48 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $10.23 Median $22.39 Typical High $44.67 | Facility | None | $10.23 | $22.39 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $16.60 Typical High $35.48 | Professional | None | $9.12 | $16.60 | $35.48 |
Emblem Health Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $21.38 | Professional | None | $6.92 | $6.92 | $21.38 |
Geisinger Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $30.90 | Facility | None | $14.79 | $14.79 | $30.90 |
Geisinger Setting Professional Modifier None Typical Low $12.59 Median $16.22 Typical High $21.88 | Professional | None | $12.59 | $16.22 | $21.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $22.91 Median $38.90 Typical High $74.13 | Facility | None | $22.91 | $38.90 | $74.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $23.99 | Professional | None | $10.00 | $10.96 | $23.99 |
Independence Blue Cross Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $144.54 | Facility | None | $43.65 | $66.07 | $144.54 |
Independence Blue Cross Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Martin's Point Setting Facility Modifier None Typical Low $12.02 Median $31.62 Typical High $56.23 | Facility | None | $12.02 | $31.62 | $56.23 |
Martin's Point Setting Professional Modifier None Typical Low $11.75 Median $12.59 Typical High $21.88 | Professional | None | $11.75 | $12.59 | $21.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.03 Median $6.03 Typical High $6.31 | Professional | 52 · Reduced service | $6.03 | $6.03 | $6.31 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $2.51 | Professional | 53 · Discontinued | $2.40 | $2.40 | $2.51 |
UPMC Health Plan Setting Facility Modifier None Typical Low $14.79 Median $46.77 Typical High $97.72 | Facility | None | $14.79 | $46.77 | $97.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $12.88 Median $14.79 Typical High $20.89 | Professional | None | $12.88 | $14.79 | $20.89 |
United Setting Facility Modifier None Typical Low $13.18 Median $17.78 Typical High $44.67 | Facility | None | $13.18 | $17.78 | $44.67 |
United Setting Professional Modifier None Typical Low $6.17 Median $9.55 Typical High $25.70 | Professional | None | $6.17 | $9.55 | $25.70 |
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 $19.95 Median $35.48 Typical High $87.10 | Facility | PN · Off-campus dept, non-excepted | $19.95 | $35.48 | $87.10 |
Where Pennsylvania sits
The same service costs 7.9 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· 15th of 51
$19.50
VT $87.10MD $10.96
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.