How much rates vary
Facilitymedian $7 · 10th to 90th $3 to $25Professionalmedian $3 · 10th to 90th $2 to $5
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 $2.95 Median $5.01 Typical High $11.75 | Facility | None | $2.95 | $5.01 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $3.09 Typical High $4.37 | Professional | None | $2.88 | $3.09 | $4.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.45 Median $1.48 Typical High $1.62 | Professional | 52 · Reduced service | $1.45 | $1.48 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.59 Typical High $0.66 | Professional | 53 · Discontinued | $0.58 | $0.59 | $0.66 |
Ambetter Setting Professional Modifier None Typical Low $1.82 Median $2.24 Typical High $2.24 | Professional | None | $1.82 | $2.24 | $2.24 |
AmeriHealth Setting Facility Modifier None Typical Low $1.70 Median $208.93 Typical High $562.34 | Facility | None | $1.70 | $208.93 | $562.34 |
Capital Blue Cross Setting Facility Modifier None Typical Low $20.89 Median $26.92 Typical High $5,011.87 | Facility | None | $20.89 | $26.92 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $8.32 | Professional | None | $2.88 | $2.88 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $5.50 Typical High $10.96 | Facility | None | $2.57 | $5.50 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $3.72 Typical High $8.71 | Professional | None | $2.34 | $3.72 | $8.71 |
Emblem Health Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $5.37 | Professional | None | $1.74 | $1.74 | $5.37 |
Geisinger Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Geisinger Setting Professional Modifier None Typical Low $3.09 Median $4.07 Typical High $5.50 | Professional | None | $3.09 | $4.07 | $5.50 |
Highmark BCBS Setting Facility Modifier None Typical Low $5.13 Median $9.77 Typical High $20.42 | Facility | None | $5.13 | $9.77 | $20.42 |
Highmark BCBS Setting Professional Modifier None Typical Low $2.19 Median $2.75 Typical High $3.09 | Professional | None | $2.19 | $2.75 | $3.09 |
Independence Blue Cross Setting Facility Modifier None Typical Low $3.47 Median $4.90 Typical High $208.93 | Facility | None | $3.47 | $4.90 | $208.93 |
Martin's Point Setting Facility Modifier None Typical Low $2.95 Median $5.25 Typical High $12.59 | Facility | None | $2.95 | $5.25 | $12.59 |
Martin's Point Setting Professional Modifier None Typical Low $2.95 Median $3.09 Typical High $4.37 | Professional | None | $2.95 | $3.09 | $4.37 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1.48 Median $1.48 Typical High $1.55 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.62 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.62 |
UPMC Health Plan Setting Facility Modifier None Typical Low $8.51 Median $17.78 Typical High $31.62 | Facility | None | $8.51 | $17.78 | $31.62 |
UPMC Health Plan Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
United Setting Facility Modifier None Typical Low $3.31 Median $4.37 Typical High $10.47 | Facility | None | $3.31 | $4.37 | $10.47 |
United Setting Professional Modifier None Typical Low $1.66 Median $2.40 Typical High $6.46 | Professional | None | $1.66 | $2.40 | $6.46 |
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 |
|---|---|---|---|---|---|
UPMC Health Plan Setting Professional Modifier QW · Waived lab test Typical Low $3.24 Median $3.63 Typical High $4.57 | Professional | QW · Waived lab test | $3.24 | $3.63 | $4.57 |
Where Pennsylvania sits
The same service costs 10.2 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· 24th of 51
$4.17
VT $28.18MD $2.75
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.