How much rates vary
Facilitymedian $8 · 10th to 90th $3 to $28Professionalmedian $3 · 10th to 90th $2 to $6
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 $3.16 Median $6.76 Typical High $27.54 | Facility | None | $3.16 | $6.76 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.31 Typical High $5.89 | Professional | None | $3.09 | $3.31 | $5.89 |
Ambetter Setting Professional Modifier None Typical Low $2.40 Median $3.89 Typical High $3.89 | Professional | None | $2.40 | $3.89 | $3.89 |
AmeriHealth Setting Facility Modifier None Typical Low $2.14 Median $5.25 Typical High $1,548.82 | Facility | None | $2.14 | $5.25 | $1,548.82 |
AmeriHealth Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | None | $2.57 | $2.57 | $2.82 |
Capital Blue Cross Setting Facility Modifier None Typical Low $22.39 Median $28.84 Typical High $5,011.87 | Facility | None | $22.39 | $28.84 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $8.91 | Professional | None | $3.09 | $3.09 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $2.75 Median $6.03 Typical High $11.75 | Facility | None | $2.75 | $6.03 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.98 Typical High $8.13 | Professional | None | $2.45 | $3.98 | $8.13 |
Emblem Health Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $5.75 | Professional | None | $1.86 | $1.86 | $5.75 |
Geisinger Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Geisinger Setting Professional Modifier None Typical Low $3.31 Median $4.37 Typical High $5.89 | Professional | None | $3.31 | $4.37 | $5.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $5.50 Median $10.96 Typical High $22.39 | Facility | None | $5.50 | $10.96 | $22.39 |
Highmark BCBS Setting Professional Modifier None Typical Low $2.34 Median $3.24 Typical High $6.61 | Professional | None | $2.34 | $3.24 | $6.61 |
Independence Blue Cross Setting Facility Modifier None Typical Low $3.47 Median $5.01 Typical High $10.47 | Facility | None | $3.47 | $5.01 | $10.47 |
Independence Blue Cross Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.63 | Professional | None | $2.51 | $2.51 | $2.63 |
Martin's Point Setting Facility Modifier None Typical Low $3.16 Median $6.76 Typical High $27.54 | Facility | None | $3.16 | $6.76 | $27.54 |
Martin's Point Setting Professional Modifier None Typical Low $3.16 Median $3.31 Typical High $6.03 | Professional | None | $3.16 | $3.31 | $6.03 |
UPMC Health Plan Setting Facility Modifier None Typical Low $9.12 Median $19.50 Typical High $34.67 | Facility | None | $9.12 | $19.50 | $34.67 |
UPMC Health Plan Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
United Setting Facility Modifier None Typical Low $3.55 Median $4.68 Typical High $10.47 | Facility | None | $3.55 | $4.68 | $10.47 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.89 Typical High $6.61 | Professional | None | $2.34 | $3.89 | $6.61 |
11 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 59 · Distinct service Typical Low $8.13 Median $9.12 Typical High $21.88 | Facility | 59 · Distinct service | $8.13 | $9.12 | $21.88 |
Aetna Setting Facility Modifier 91 · Repeat lab test Typical Low $9.12 Median $28.18 Typical High $83.18 | Facility | 91 · Repeat lab test | $9.12 | $28.18 | $83.18 |
Aetna Setting Facility Modifier QW · Waived lab test Typical Low $19.95 Median $45.71 Typical High $87.10 | Facility | QW · Waived lab test | $19.95 | $45.71 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.55 Median $1.58 Typical High $1.78 | Professional | 52 · Reduced service | $1.55 | $1.58 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.65 Typical High $0.71 | Professional | 53 · Discontinued | $0.62 | $0.65 | $0.71 |
Highmark BCBS Setting Facility Modifier 59 · Distinct service Typical Low $6.31 Median $9.33 Typical High $20.42 | Facility | 59 · Distinct service | $6.31 | $9.33 | $20.42 |
Highmark BCBS Setting Facility Modifier 91 · Repeat lab test Typical Low $6.17 Median $12.59 Typical High $21.88 | Facility | 91 · Repeat lab test | $6.17 | $12.59 | $21.88 |
Highmark BCBS Setting Facility Modifier XU · Unusual separate service Typical Low $5.75 Median $9.77 Typical High $23.44 | Facility | XU · Unusual separate service | $5.75 | $9.77 | $23.44 |
Martin's Point Setting Facility Modifier 91 · Repeat lab test Typical Low $9.12 Median $36.31 Typical High $83.18 | Facility | 91 · Repeat lab test | $9.12 | $36.31 | $83.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1.58 Median $1.58 Typical High $1.66 | Professional | 52 · Reduced service | $1.58 | $1.58 | $1.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.68 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.68 |
Where Pennsylvania sits
The same service costs 12.6 times more in Vermont than in Washington, DC. 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· 23rd of 51
$4.57
VT $39.81DC $3.16
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.