How much rates vary
Facilitymedian $42 · 10th to 90th $14 to $115Professionalmedian $14 · 10th to 90th $9 to $25
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 $13.80 Median $29.51 Typical High $66.07 | Facility | None | $13.80 | $29.51 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $14.45 Typical High $22.39 | Professional | None | $13.18 | $14.45 | $22.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $6.92 Typical High $7.59 | Professional | 52 · Reduced service | $6.76 | $6.92 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.75 Typical High $3.02 | Professional | 53 · Discontinued | $2.69 | $2.75 | $3.02 |
Ambetter Setting Professional Modifier None Typical Low $3.39 Median $10.47 Typical High $16.98 | Professional | None | $3.39 | $10.47 | $16.98 |
AmeriHealth Setting Facility Modifier None Typical Low $28.84 Median $81.28 Typical High $549.54 | Facility | None | $28.84 | $81.28 | $549.54 |
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 $97.72 Median $125.89 Typical High $5,011.87 | Facility | None | $97.72 | $125.89 | $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 $51.29 | Facility | None | $11.75 | $25.70 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $19.05 Typical High $40.74 | Professional | None | $10.47 | $19.05 | $40.74 |
Emblem Health Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $24.55 | Professional | None | $7.94 | $7.94 | $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 $14.45 Median $19.05 Typical High $25.70 | Professional | None | $14.45 | $19.05 | $25.70 |
Highmark BCBS Setting Facility Modifier None Typical Low $23.44 Median $47.86 Typical High $100.00 | Facility | None | $23.44 | $47.86 | $100.00 |
Highmark BCBS Setting Professional Modifier None Typical Low $11.22 Median $12.59 Typical High $17.38 | Professional | None | $11.22 | $12.59 | $17.38 |
Independence Blue Cross Setting Facility Modifier None Typical Low $23.99 Median $77.62 Typical High $676.08 | Facility | None | $23.99 | $77.62 | $676.08 |
Independence Blue Cross Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | None | $10.96 | $10.96 | $11.48 |
Martin's Point Setting Facility Modifier None Typical Low $13.80 Median $34.67 Typical High $74.13 | Facility | None | $13.80 | $34.67 | $74.13 |
Martin's Point Setting Professional Modifier None Typical Low $13.49 Median $14.45 Typical High $22.39 | Professional | None | $13.49 | $14.45 | $22.39 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.92 Median $6.92 Typical High $7.24 | Professional | 52 · Reduced service | $6.92 | $6.92 | $7.24 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $2.88 | Professional | 53 · Discontinued | $2.75 | $2.75 | $2.88 |
UPMC Health Plan Setting Facility Modifier None Typical Low $16.98 Median $52.48 Typical High $109.65 | Facility | None | $16.98 | $52.48 | $109.65 |
UPMC Health Plan Setting Professional Modifier None Typical Low $14.79 Median $16.98 Typical High $23.99 | Professional | None | $14.79 | $16.98 | $23.99 |
United Setting Facility Modifier None Typical Low $15.14 Median $16.98 Typical High $20.42 | Facility | None | $15.14 | $16.98 | $20.42 |
United Setting Professional Modifier None Typical Low $7.59 Median $10.96 Typical High $29.51 | Professional | None | $7.59 | $10.96 | $29.51 |
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 $8.13 Median $41.69 Typical High $112.20 | Facility | PN · Off-campus dept, non-excepted | $8.13 | $41.69 | $112.20 |
Where Pennsylvania sits
The same service costs 8.5 times more in Vermont than in Rhode Island. 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
$21.38
VT $107RI $12.59
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.