How much rates vary
Facilitymedian $47 · 10th to 90th $16 to $115Professionalmedian $15 · 10th to 90th $11 to $28
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 $15.14 Median $36.31 Typical High $91.20 | Facility | None | $15.14 | $36.31 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $15.85 Typical High $25.12 | Professional | None | $14.45 | $15.85 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $7.59 Typical High $8.32 | Professional | 52 · Reduced service | $7.41 | $7.59 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $3.02 Typical High $3.31 | Professional | 53 · Discontinued | $2.95 | $3.02 | $3.31 |
Ambetter Setting Professional Modifier None Typical Low $11.22 Median $18.62 Typical High $18.62 | Professional | None | $11.22 | $18.62 | $18.62 |
AmeriHealth Setting Facility Modifier None Typical Low $31.62 Median $89.13 Typical High $1,202.26 | Facility | None | $31.62 | $89.13 | $1,202.26 |
AmeriHealth Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Capital Blue Cross Setting Facility Modifier None Typical Low $107.15 Median $138.04 Typical High $5,011.87 | Facility | None | $107.15 | $138.04 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $18.20 | Professional | None | $14.45 | $14.45 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $12.88 Median $28.18 Typical High $56.23 | Facility | None | $12.88 | $28.18 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $18.62 Typical High $38.02 | Professional | None | $11.48 | $18.62 | $38.02 |
Emblem Health Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $26.92 | Professional | None | $8.71 | $8.71 | $26.92 |
Geisinger Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Geisinger Setting Professional Modifier None Typical Low $15.85 Median $20.89 Typical High $28.18 | Professional | None | $15.85 | $20.89 | $28.18 |
Highmark BCBS Setting Facility Modifier None Typical Low $27.54 Median $52.48 Typical High $109.65 | Facility | None | $27.54 | $52.48 | $109.65 |
Highmark BCBS Setting Professional Modifier None Typical Low $12.30 Median $13.80 Typical High $15.85 | Professional | None | $12.30 | $13.80 | $15.85 |
Independence Blue Cross Setting Facility Modifier None Typical Low $25.70 Median $79.43 Typical High $165.96 | Facility | None | $25.70 | $79.43 | $165.96 |
Independence Blue Cross Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Martin's Point Setting Facility Modifier None Typical Low $15.14 Median $39.81 Typical High $91.20 | Facility | None | $15.14 | $39.81 | $91.20 |
Martin's Point Setting Professional Modifier None Typical Low $15.14 Median $15.85 Typical High $25.70 | Professional | None | $15.14 | $15.85 | $25.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $7.59 Median $7.59 Typical High $7.94 | Professional | 52 · Reduced service | $7.59 | $7.59 | $7.94 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $3.16 | Professional | 53 · Discontinued | $3.02 | $3.02 | $3.16 |
UPMC Health Plan Setting Facility Modifier None Typical Low $42.66 Median $61.66 Typical High $109.65 | Facility | None | $42.66 | $61.66 | $109.65 |
UPMC Health Plan Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
United Setting Facility Modifier None Typical Low $16.60 Median $22.39 Typical High $89.13 | Facility | None | $16.60 | $22.39 | $89.13 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.02 Typical High $32.36 | Professional | None | $8.32 | $12.02 | $32.36 |
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 $8.91 Median $45.71 Typical High $128.82 | Facility | PN · Off-campus dept, non-excepted | $8.91 | $45.71 | $128.82 |
Where Pennsylvania sits
The same service costs 6.8 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
$24.55
VT $95.50MD $14.13
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.