How much rates vary
Facilitymedian $23 · 10th to 90th $8 to $60Professionalmedian $8 · 10th to 90th $5 to $14
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 $7.24 Median $12.02 Typical High $33.88 | Facility | None | $7.24 | $12.02 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $7.59 Typical High $12.59 | Professional | None | $7.08 | $7.59 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.55 Median $3.63 Typical High $4.07 | Professional | 52 · Reduced service | $3.55 | $3.63 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.62 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.62 |
Ambetter Setting Professional Modifier None Typical Low $1.82 Median $5.50 Typical High $9.12 | Professional | None | $1.82 | $5.50 | $9.12 |
AmeriHealth Setting Facility Modifier None Typical Low $17.38 Median $42.66 Typical High $741.31 | Facility | None | $17.38 | $42.66 | $741.31 |
AmeriHealth Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $10.47 | Professional | None | $5.89 | $5.89 | $10.47 |
Capital Blue Cross Setting Facility Modifier None Typical Low $51.29 Median $66.07 Typical High $5,011.87 | Facility | None | $51.29 | $66.07 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $8.91 | Professional | None | $7.08 | $7.08 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $6.31 Median $13.80 Typical High $26.92 | Facility | None | $6.31 | $13.80 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $10.23 Typical High $21.88 | Professional | None | $5.62 | $10.23 | $21.88 |
Emblem Health Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $13.18 | Professional | None | $4.27 | $4.27 | $13.18 |
Geisinger Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Geisinger Setting Professional Modifier None Typical Low $7.59 Median $10.00 Typical High $13.49 | Professional | None | $7.59 | $10.00 | $13.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $14.13 Median $27.54 Typical High $57.54 | Facility | None | $14.13 | $27.54 | $57.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $5.37 Median $6.76 Typical High $9.12 | Professional | None | $5.37 | $6.76 | $9.12 |
Independence Blue Cross Setting Facility Modifier None Typical Low $12.88 Median $37.15 Typical High $741.31 | Facility | None | $12.88 | $37.15 | $741.31 |
Independence Blue Cross Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.17 | Professional | None | $5.89 | $5.89 | $6.17 |
Martin's Point Setting Facility Modifier None Typical Low $7.24 Median $11.75 Typical High $45.71 | Facility | None | $7.24 | $11.75 | $45.71 |
Martin's Point Setting Professional Modifier None Typical Low $7.24 Median $7.59 Typical High $13.80 | Professional | None | $7.24 | $7.59 | $13.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $3.63 Median $3.63 Typical High $3.80 | Professional | 52 · Reduced service | $3.63 | $3.63 | $3.80 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.51 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.51 |
UPMC Health Plan Setting Facility Modifier None Typical Low $9.12 Median $30.20 Typical High $63.10 | Facility | None | $9.12 | $30.20 | $63.10 |
UPMC Health Plan Setting Professional Modifier None Typical Low $7.94 Median $9.12 Typical High $12.88 | Professional | None | $7.94 | $9.12 | $12.88 |
United Setting Facility Modifier None Typical Low $8.13 Median $9.12 Typical High $10.72 | Facility | None | $8.13 | $9.12 | $10.72 |
United Setting Professional Modifier None Typical Low $4.07 Median $6.03 Typical High $15.85 | Professional | None | $4.07 | $6.03 | $15.85 |
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 $7.41 Median $21.88 Typical High $70.79 | Facility | PN · Off-campus dept, non-excepted | $7.41 | $21.88 | $70.79 |
Where Pennsylvania sits
The same service costs 10.7 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· 15th of 51
$11.48
VT $74.13MD $6.92
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.