How much rates vary
Facilitymedian $45 · 10th to 90th $16 to $105Professionalmedian $14 · 10th to 90th $9 to $26
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 $13.49 Median $37.15 Typical High $93.33 | Facility | None | $13.49 | $37.15 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $14.13 Typical High $23.44 | Professional | None | $13.18 | $14.13 | $23.44 |
Ambetter Setting Professional Modifier None Typical Low $3.39 Median $10.23 Typical High $16.98 | Professional | None | $3.39 | $10.23 | $16.98 |
AmeriHealth Setting Facility Modifier None Typical Low $33.11 Median $81.28 Typical High $954.99 | Facility | None | $33.11 | $81.28 | $954.99 |
AmeriHealth Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | None | $10.96 | $10.96 | $11.48 |
Capital Blue Cross Setting Facility Modifier None Typical Low $95.50 Median $123.03 Typical High $5,011.87 | Facility | None | $95.50 | $123.03 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $16.60 | Professional | None | $13.18 | $13.18 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $25.70 Typical High $50.12 | Facility | None | $11.75 | $25.70 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $16.98 Typical High $34.67 | Professional | None | $10.47 | $16.98 | $34.67 |
Emblem Health Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $24.55 | Professional | None | $3.47 | $3.47 | $24.55 |
Geisinger Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Geisinger Setting Professional Modifier None Typical Low $14.13 Median $18.62 Typical High $25.12 | Professional | None | $14.13 | $18.62 | $25.12 |
Highmark BCBS Setting Facility Modifier None Typical Low $28.18 Median $47.86 Typical High $91.20 | Facility | None | $28.18 | $47.86 | $91.20 |
Highmark BCBS Setting Professional Modifier None Typical Low $11.22 Median $12.59 Typical High $27.54 | Professional | None | $11.22 | $12.59 | $27.54 |
Independence Blue Cross Setting Facility Modifier None Typical Low $23.99 Median $70.79 Typical High $165.96 | Facility | None | $23.99 | $70.79 | $165.96 |
Independence Blue Cross Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Martin's Point Setting Facility Modifier None Typical Low $13.49 Median $38.90 Typical High $93.33 | Facility | None | $13.49 | $38.90 | $93.33 |
Martin's Point Setting Professional Modifier None Typical Low $13.49 Median $14.13 Typical High $25.12 | Professional | None | $13.49 | $14.13 | $25.12 |
UPMC Health Plan Setting Facility Modifier None Typical Low $38.90 Median $64.57 Typical High $114.82 | Facility | None | $38.90 | $64.57 | $114.82 |
UPMC Health Plan Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
United Setting Facility Modifier None Typical Low $5.89 Median $16.98 Typical High $60.26 | Facility | None | $5.89 | $16.98 | $60.26 |
United Setting Professional Modifier None Typical Low $7.59 Median $10.96 Typical High $29.51 | Professional | None | $7.59 | $10.96 | $29.51 |
5 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.61 Median $6.76 Typical High $7.59 | Professional | 52 · Reduced service | $6.61 | $6.76 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.69 Typical High $3.02 | Professional | 53 · Discontinued | $2.63 | $2.69 | $3.02 |
Highmark BCBS Setting Facility Modifier PN · Off-campus dept, non-excepted Typical Low $13.80 Median $48.98 Typical High $100.00 | Facility | PN · Off-campus dept, non-excepted | $13.80 | $48.98 | $100.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 52 · Reduced service | $6.76 | $6.76 | $7.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $2.88 | Professional | 53 · Discontinued | $2.69 | $2.69 | $2.88 |
Where Pennsylvania sits
The same service costs 7.8 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· 14th of 51
$23.44
VT $105MD $13.49
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.