How much rates vary
Facilitymedian $10 · 10th to 90th $4 to $27Professionalmedian $4 · 10th to 90th $3 to $7
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 $3.63 Median $8.51 Typical High $22.91 | Facility | None | $3.63 | $8.51 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.80 Typical High $6.31 | Professional | None | $3.55 | $3.80 | $6.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.78 Median $1.82 Typical High $2.04 | Professional | 52 · Reduced service | $1.78 | $1.82 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.72 Typical High $0.81 | Professional | 53 · Discontinued | $0.71 | $0.72 | $0.81 |
Ambetter Setting Professional Modifier None Typical Low $2.69 Median $4.47 Typical High $4.47 | Professional | None | $2.69 | $4.47 | $4.47 |
AmeriHealth Setting Facility Modifier None Typical Low $2.14 Median $5.37 Typical High $371.54 | Facility | None | $2.14 | $5.37 | $371.54 |
AmeriHealth Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Capital Blue Cross Setting Facility Modifier None Typical Low $25.70 Median $33.11 Typical High $5,011.87 | Facility | None | $25.70 | $33.11 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $10.23 | Professional | None | $3.55 | $3.55 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $6.92 Typical High $13.49 | Facility | None | $3.16 | $6.92 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $4.79 Typical High $10.72 | Professional | None | $2.82 | $4.79 | $10.72 |
Emblem Health Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $6.61 | Professional | None | $2.14 | $2.14 | $6.61 |
Geisinger Setting Facility Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Facility | None | $4.57 | $4.57 | $4.57 |
Geisinger Setting Professional Modifier None Typical Low $3.80 Median $5.01 Typical High $6.76 | Professional | None | $3.80 | $5.01 | $6.76 |
Highmark BCBS Setting Facility Modifier None Typical Low $6.76 Median $12.88 Typical High $26.92 | Facility | None | $6.76 | $12.88 | $26.92 |
Highmark BCBS Setting Professional Modifier None Typical Low $2.69 Median $3.39 Typical High $4.37 | Professional | None | $2.69 | $3.39 | $4.37 |
Independence Blue Cross Setting Facility Modifier None Typical Low $3.24 Median $5.01 Typical High $173.78 | Facility | None | $3.24 | $5.01 | $173.78 |
Independence Blue Cross Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Martin's Point Setting Facility Modifier None Typical Low $3.63 Median $9.33 Typical High $22.91 | Facility | None | $3.63 | $9.33 | $22.91 |
Martin's Point Setting Professional Modifier None Typical Low $3.63 Median $3.80 Typical High $6.92 | Professional | None | $3.63 | $3.80 | $6.92 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1.82 Median $1.82 Typical High $1.91 | Professional | 52 · Reduced service | $1.82 | $1.82 | $1.91 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $0.78 | Professional | 53 · Discontinued | $0.72 | $0.72 | $0.78 |
UPMC Health Plan Setting Facility Modifier None Typical Low $10.47 Median $21.38 Typical High $38.02 | Facility | None | $10.47 | $21.38 | $38.02 |
UPMC Health Plan Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
United Setting Facility Modifier None Typical Low $4.07 Median $5.37 Typical High $10.47 | Facility | None | $4.07 | $5.37 | $10.47 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.95 Typical High $7.94 | Professional | None | $2.04 | $2.95 | $7.94 |
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 $3.72 Median $12.30 Typical High $26.92 | Facility | PN · Off-campus dept, non-excepted | $3.72 | $12.30 | $26.92 |
Where Pennsylvania sits
The same service costs 15.8 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· 19th of 51
$5.37
VT $54.95MD $3.47
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.