How much rates vary
Facilitymedian $17 · 10th to 90th $6 to $48Professionalmedian $6 · 10th to 90th $4 to $10
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 $5.37 Median $13.80 Typical High $38.90 | Facility | None | $5.37 | $13.80 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $9.33 | Professional | None | $5.25 | $5.75 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $2.69 Typical High $3.02 | Professional | 52 · Reduced service | $2.63 | $2.69 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.10 Typical High $1.20 | Professional | 53 · Discontinued | $1.07 | $1.10 | $1.20 |
Ambetter Setting Professional Modifier None Typical Low $3.98 Median $4.07 Typical High $10.72 | Professional | None | $3.98 | $4.07 | $10.72 |
AmeriHealth Setting Facility Modifier None Typical Low $10.96 Median $35.48 Typical High $1,819.70 | Facility | None | $10.96 | $35.48 | $1,819.70 |
AmeriHealth Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | None | $4.37 | $4.37 | $4.57 |
Capital Blue Cross Setting Facility Modifier None Typical Low $38.02 Median $50.12 Typical High $5,011.87 | Facility | None | $38.02 | $50.12 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.61 | Professional | None | $5.25 | $5.25 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $10.23 Typical High $19.95 | Facility | None | $4.68 | $10.23 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $4.17 Median $7.59 Typical High $16.22 | Professional | None | $4.17 | $7.59 | $16.22 |
Emblem Health Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $9.77 | Professional | None | $3.16 | $3.16 | $9.77 |
Geisinger Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Geisinger Setting Professional Modifier None Typical Low $5.75 Median $7.41 Typical High $10.00 | Professional | None | $5.75 | $7.41 | $10.00 |
Highmark BCBS Setting Facility Modifier None Typical Low $11.48 Median $19.50 Typical High $41.69 | Facility | None | $11.48 | $19.50 | $41.69 |
Highmark BCBS Setting Professional Modifier None Typical Low $3.98 Median $5.01 Typical High $6.46 | Professional | None | $3.98 | $5.01 | $6.46 |
Independence Blue Cross Setting Facility Modifier None Typical Low $10.47 Median $35.48 Typical High $1,513.56 | Facility | None | $10.47 | $35.48 | $1,513.56 |
Independence Blue Cross Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | None | $4.37 | $4.37 | $4.57 |
Martin's Point Setting Facility Modifier None Typical Low $5.37 Median $14.79 Typical High $38.90 | Facility | None | $5.37 | $14.79 | $38.90 |
Martin's Point Setting Professional Modifier None Typical Low $5.37 Median $5.75 Typical High $10.00 | Professional | None | $5.37 | $5.75 | $10.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2.69 Median $2.69 Typical High $2.82 | Professional | 52 · Reduced service | $2.69 | $2.69 | $2.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.12 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.12 |
UPMC Health Plan Setting Facility Modifier None Typical Low $6.76 Median $16.60 Typical High $29.51 | Facility | None | $6.76 | $16.60 | $29.51 |
UPMC Health Plan Setting Professional Modifier None Typical Low $5.89 Median $6.76 Typical High $9.55 | Professional | None | $5.89 | $6.76 | $9.55 |
United Setting Facility Modifier None Typical Low $2.24 Median $6.76 Typical High $20.89 | Facility | None | $2.24 | $6.76 | $20.89 |
United Setting Professional Modifier None Typical Low $3.02 Median $4.79 Typical High $11.75 | Professional | None | $3.02 | $4.79 | $11.75 |
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 $19.05 Typical High $42.66 | Facility | PN · Off-campus dept, non-excepted | $8.91 | $19.05 | $42.66 |
Where Pennsylvania sits
The same service costs 10.0 times more in Minnesota 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
$8.91
MN $51.29MD $5.13
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.