How much rates vary
Facilitymedian $43 · 10th to 90th $15 to $102Professionalmedian $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 $14.79 Median $25.12 Typical High $66.07 | Facility | None | $14.79 | $25.12 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $15.49 Typical High $25.12 | Professional | None | $14.45 | $15.49 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.24 Median $7.41 Typical High $8.32 | Professional | 52 · Reduced service | $7.24 | $7.41 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.95 Typical High $3.31 | Professional | 53 · Discontinued | $2.88 | $2.95 | $3.31 |
Ambetter Setting Professional Modifier None Typical Low $9.12 Median $18.20 Typical High $29.51 | Professional | None | $9.12 | $18.20 | $29.51 |
AmeriHealth Setting Facility Modifier None Typical Low $26.30 Median $74.13 Typical High $165.96 | Facility | None | $26.30 | $74.13 | $165.96 |
AmeriHealth Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | None | $12.02 | $12.02 | $12.30 |
Capital Blue Cross Setting Facility Modifier None Typical Low $104.71 Median $134.90 Typical High $5,011.87 | Facility | None | $104.71 | $134.90 | $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 $54.95 | Facility | None | $12.88 | $28.18 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $20.89 Typical High $44.67 | Professional | None | $11.48 | $20.89 | $44.67 |
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 $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Geisinger Setting Professional Modifier None Typical Low $15.49 Median $20.42 Typical High $27.54 | Professional | None | $15.49 | $20.42 | $27.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $28.84 Median $52.48 Typical High $91.20 | Facility | None | $28.84 | $52.48 | $91.20 |
Highmark BCBS Setting Professional Modifier None Typical Low $10.96 Median $13.80 Typical High $15.49 | Professional | None | $10.96 | $13.80 | $15.49 |
Independence Blue Cross Setting Facility Modifier None Typical Low $25.70 Median $70.79 Typical High $165.96 | Facility | None | $25.70 | $70.79 | $165.96 |
Independence Blue Cross Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | None | $12.02 | $12.02 | $12.30 |
Martin's Point Setting Facility Modifier None Typical Low $14.79 Median $25.12 Typical High $66.07 | Facility | None | $14.79 | $25.12 | $66.07 |
Martin's Point Setting Professional Modifier None Typical Low $14.79 Median $15.49 Typical High $25.70 | Professional | None | $14.79 | $15.49 | $25.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $7.41 Typical High $7.76 | Professional | 52 · Reduced service | $7.41 | $7.41 | $7.76 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $3.16 | Professional | 53 · Discontinued | $2.95 | $2.95 | $3.16 |
UPMC Health Plan Setting Facility Modifier None Typical Low $18.20 Median $48.98 Typical High $102.33 | Facility | None | $18.20 | $48.98 | $102.33 |
UPMC Health Plan Setting Professional Modifier None Typical Low $16.22 Median $18.20 Typical High $26.30 | Professional | None | $16.22 | $18.20 | $26.30 |
United Setting Facility Modifier None Typical Low $16.60 Median $18.20 Typical High $21.88 | Facility | None | $16.60 | $18.20 | $21.88 |
United Setting Professional Modifier None Typical Low $8.32 Median $13.18 Typical High $32.36 | Professional | None | $8.32 | $13.18 | $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 $8.71 Median $41.69 Typical High $114.82 | Facility | PN · Off-campus dept, non-excepted | $8.71 | $41.69 | $114.82 |
Where Pennsylvania sits
The same service costs 7.1 times more in Vermont than in Illinois. 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· 17th of 51
$21.88
VT $100IL $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.