How much rates vary
Facilitymedian $21 · 10th to 90th $9 to $62Professionalmedian $9 · 10th to 90th $5 to $15
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 $8.51 Median $13.18 Typical High $54.95 | Facility | None | $8.51 | $13.18 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.71 Typical High $14.13 | Professional | None | $8.32 | $8.71 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.17 Median $4.27 Typical High $4.47 | Professional | 52 · Reduced service | $4.17 | $4.27 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.70 Typical High $1.78 | Professional | 53 · Discontinued | $1.66 | $1.70 | $1.78 |
Ambetter Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
AmeriHealth Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
AmeriHealth Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | None | $6.76 | $6.76 | $7.08 |
Capital Blue Cross Setting Facility Modifier None Typical Low $54.95 Median $70.79 Typical High $5,011.87 | Facility | None | $54.95 | $70.79 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.33 | Professional | None | $8.13 | $8.13 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $15.49 Typical High $31.62 | Facility | None | $7.41 | $15.49 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $10.72 Typical High $23.44 | Professional | None | $6.03 | $10.72 | $23.44 |
Emblem Health Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $15.14 | Professional | None | $4.90 | $4.90 | $15.14 |
Geisinger Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Geisinger Setting Professional Modifier None Typical Low $8.91 Median $10.72 Typical High $15.85 | Professional | None | $8.91 | $10.72 | $15.85 |
Highmark BCBS Setting Facility Modifier None Typical Low $16.98 Median $29.51 Typical High $46.77 | Facility | None | $16.98 | $29.51 | $46.77 |
Highmark BCBS Setting Professional Modifier None Typical Low $6.92 Median $7.08 Typical High $8.71 | Professional | None | $6.92 | $7.08 | $8.71 |
Independence Blue Cross Setting Facility Modifier None Typical Low $75.86 Median $199.53 Typical High $257.04 | Facility | None | $75.86 | $199.53 | $257.04 |
Independence Blue Cross Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | None | $6.76 | $6.76 | $7.08 |
Martin's Point Setting Facility Modifier None Typical Low $8.51 Median $12.30 Typical High $58.88 | Facility | None | $8.51 | $12.30 | $58.88 |
Martin's Point Setting Professional Modifier None Typical Low $8.51 Median $8.71 Typical High $12.59 | Professional | None | $8.51 | $8.71 | $12.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $4.27 Median $4.27 Typical High $4.47 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $1.78 | Professional | 53 · Discontinued | $1.70 | $1.70 | $1.78 |
UPMC Health Plan Setting Facility Modifier None Typical Low $19.50 Median $25.70 Typical High $39.81 | Facility | None | $19.50 | $25.70 | $39.81 |
UPMC Health Plan Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
United Setting Facility Modifier None Typical Low $9.33 Median $10.47 Typical High $12.59 | Facility | None | $9.33 | $10.47 | $12.59 |
United Setting Professional Modifier None Typical Low $4.37 Median $6.76 Typical High $16.60 | Professional | None | $4.37 | $6.76 | $16.60 |
4 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 $9.77 Median $24.55 Typical High $91.20 | Facility | 59 · Distinct service | $9.77 | $24.55 | $91.20 |
Highmark BCBS Setting Facility Modifier 59 · Distinct service Typical Low $19.95 Median $26.30 Typical High $44.67 | Facility | 59 · Distinct service | $19.95 | $26.30 | $44.67 |
Highmark BCBS Setting Facility Modifier XU · Unusual separate service Typical Low $13.80 Median $34.67 Typical High $51.29 | Facility | XU · Unusual separate service | $13.80 | $34.67 | $51.29 |
Martin's Point Setting Facility Modifier 59 · Distinct service Typical Low $9.77 Median $24.55 Typical High $91.20 | Facility | 59 · Distinct service | $9.77 | $24.55 | $91.20 |
Where Pennsylvania sits
The same service costs 5.6 times more in Minnesota than in New Jersey. 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· 28th of 51
$10.47
MN $41.69NJ $7.41
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.