How much rates vary
Facilitymedian $27 · 10th to 90th $9 to $69Professionalmedian $9 · 10th to 90th $6 to $22
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 $8.71 Median $16.98 Typical High $47.86 | Facility | None | $8.71 | $16.98 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $9.12 Typical High $19.50 | Professional | None | $8.51 | $9.12 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.27 Median $4.37 Typical High $4.79 | Professional | 52 · Reduced service | $4.27 | $4.37 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.74 Typical High $1.91 | Professional | 53 · Discontinued | $1.70 | $1.74 | $1.91 |
Ambetter Setting Professional Modifier None Typical Low $6.61 Median $10.72 Typical High $10.72 | Professional | None | $6.61 | $10.72 | $10.72 |
AmeriHealth Setting Facility Modifier None Typical Low $21.88 Median $54.95 Typical High $478.63 | Facility | None | $21.88 | $54.95 | $478.63 |
Capital Blue Cross Setting Facility Modifier None Typical Low $61.66 Median $79.43 Typical High $5,011.87 | Facility | None | $61.66 | $79.43 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $11.22 | Professional | None | $8.32 | $8.32 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $16.22 Typical High $32.36 | Facility | None | $7.59 | $16.22 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $18.20 Typical High $44.67 | Professional | None | $13.49 | $18.20 | $44.67 |
Emblem Health Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $15.49 | Professional | None | $5.01 | $5.01 | $15.49 |
Geisinger Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Geisinger Setting Professional Modifier None Typical Low $9.12 Median $12.02 Typical High $16.22 | Professional | None | $9.12 | $12.02 | $16.22 |
Highmark BCBS Setting Facility Modifier None Typical Low $15.49 Median $30.20 Typical High $54.95 | Facility | None | $15.49 | $30.20 | $54.95 |
Highmark BCBS Setting Professional Modifier None Typical Low $7.08 Median $8.13 Typical High $9.12 | Professional | None | $7.08 | $8.13 | $9.12 |
Independence Blue Cross Setting Facility Modifier None Typical Low $21.88 Median $50.12 Typical High $112.20 | Facility | None | $21.88 | $50.12 | $112.20 |
Martin's Point Setting Facility Modifier None Typical Low $8.71 Median $22.39 Typical High $47.86 | Facility | None | $8.71 | $22.39 | $47.86 |
Martin's Point Setting Professional Modifier None Typical Low $8.71 Median $9.12 Typical High $18.62 | Professional | None | $8.71 | $9.12 | $18.62 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | 52 · Reduced service | $4.37 | $4.37 | $4.57 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.82 | Professional | 53 · Discontinued | $1.74 | $1.74 | $1.82 |
UPMC Health Plan Setting Facility Modifier None Typical Low $10.72 Median $34.67 Typical High $72.44 | Facility | None | $10.72 | $34.67 | $72.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $9.33 Median $10.72 Typical High $19.95 | Professional | None | $9.33 | $10.72 | $19.95 |
United Setting Facility Modifier None Typical Low $9.77 Median $12.88 Typical High $30.20 | Facility | None | $9.77 | $12.88 | $30.20 |
United Setting Professional Modifier None Typical Low $4.47 Median $6.92 Typical High $18.62 | Professional | None | $4.47 | $6.92 | $18.62 |
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 $26.30 Typical High $67.61 | Facility | PN · Off-campus dept, non-excepted | $8.71 | $26.30 | $67.61 |
Where Pennsylvania sits
The same service costs 7.9 times more in Vermont than in Washington, DC. 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
$14.79
VT $67.61DC $8.51
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.