How much rates vary
Facilitymedian $62 · 10th to 90th $22 to $162Professionalmedian $22 · 10th to 90th $15 to $39
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 $20.89 Median $39.81 Typical High $117.49 | Facility | None | $20.89 | $39.81 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $21.88 Typical High $34.67 | Professional | None | $19.95 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.47 Typical High $11.48 | Professional | 52 · Reduced service | $10.23 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.17 Typical High $4.57 | Professional | 53 · Discontinued | $4.07 | $4.17 | $4.57 |
Ambetter Setting Professional Modifier None Typical Low $5.13 Median $15.85 Typical High $25.70 | Professional | None | $5.13 | $15.85 | $25.70 |
AmeriHealth Setting Facility Modifier None Typical Low $57.54 Median $229.09 Typical High $7,943.28 | Facility | None | $57.54 | $229.09 | $7,943.28 |
AmeriHealth Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $17.38 | Professional | None | $16.60 | $16.60 | $17.38 |
Capital Blue Cross Setting Facility Modifier None Typical Low $147.91 Median $190.55 Typical High $5,011.87 | Facility | None | $147.91 | $190.55 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $25.70 | Professional | None | $19.95 | $19.95 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $38.90 Typical High $77.62 | Facility | None | $18.20 | $38.90 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $28.84 Typical High $63.10 | Professional | None | $16.22 | $28.84 | $63.10 |
Emblem Health Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $37.15 | Professional | None | $12.02 | $12.02 | $37.15 |
Geisinger Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Geisinger Setting Professional Modifier None Typical Low $21.88 Median $28.84 Typical High $38.90 | Professional | None | $21.88 | $28.84 | $38.90 |
Highmark BCBS Setting Facility Modifier None Typical Low $38.02 Median $69.18 Typical High $144.54 | Facility | None | $38.02 | $69.18 | $144.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $15.49 Median $19.50 Typical High $21.88 | Professional | None | $15.49 | $19.50 | $21.88 |
Independence Blue Cross Setting Facility Modifier None Typical Low $29.51 Median $107.15 Typical High $4,677.35 | Facility | None | $29.51 | $107.15 | $4,677.35 |
Independence Blue Cross Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $17.38 | Professional | None | $16.60 | $16.60 | $17.38 |
Martin's Point Setting Facility Modifier None Typical Low $20.89 Median $40.74 Typical High $128.82 | Facility | None | $20.89 | $40.74 | $128.82 |
Martin's Point Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $35.48 | Professional | None | $20.89 | $21.88 | $35.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.47 Typical High $10.96 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.37 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.37 |
UPMC Health Plan Setting Facility Modifier None Typical Low $25.70 Median $70.79 Typical High $147.91 | Facility | None | $25.70 | $70.79 | $147.91 |
UPMC Health Plan Setting Professional Modifier None Typical Low $22.91 Median $25.70 Typical High $37.15 | Professional | None | $22.91 | $25.70 | $37.15 |
United Setting Facility Modifier None Typical Low $23.44 Median $30.90 Typical High $104.71 | Facility | None | $23.44 | $30.90 | $104.71 |
United Setting Professional Modifier None Typical Low $11.48 Median $16.60 Typical High $44.67 | Professional | None | $11.48 | $16.60 | $44.67 |
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 $12.30 Median $54.95 Typical High $158.49 | Facility | PN · Off-campus dept, non-excepted | $12.30 | $54.95 | $158.49 |
Where Pennsylvania sits
The same service costs 7.4 times more in Vermont than in Alabama. 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
$30.90
VT $138AL $18.62
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.