How much rates vary
Facilitymedian $15 · 10th to 90th $5 to $45Professionalmedian $5 · 10th to 90th $4 to $9
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 $4.90 Median $12.30 Typical High $34.67 | Facility | None | $4.90 | $12.30 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $5.13 Typical High $8.13 | Professional | None | $4.79 | $5.13 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.40 Median $2.45 Typical High $2.69 | Professional | 52 · Reduced service | $2.40 | $2.45 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.98 Typical High $1.07 | Professional | 53 · Discontinued | $0.95 | $0.98 | $1.07 |
Ambetter Setting Professional Modifier None Typical Low $3.72 Median $6.03 Typical High $6.03 | Professional | None | $3.72 | $6.03 | $6.03 |
AmeriHealth Setting Facility Modifier None Typical Low $13.49 Median $31.62 Typical High $2,398.83 | Facility | None | $13.49 | $31.62 | $2,398.83 |
AmeriHealth Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Capital Blue Cross Setting Facility Modifier None Typical Low $34.67 Median $44.67 Typical High $5,011.87 | Facility | None | $34.67 | $44.67 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $13.49 | Professional | None | $4.68 | $4.68 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $9.12 Typical High $18.20 | Facility | None | $4.17 | $9.12 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $6.92 Typical High $14.45 | Professional | None | $3.72 | $6.92 | $14.45 |
Emblem Health Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $8.71 | Professional | None | $2.82 | $2.82 | $8.71 |
Geisinger Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Geisinger Setting Professional Modifier None Typical Low $5.13 Median $6.76 Typical High $9.12 | Professional | None | $5.13 | $6.76 | $9.12 |
Highmark BCBS Setting Facility Modifier None Typical Low $8.51 Median $16.98 Typical High $37.15 | Facility | None | $8.51 | $16.98 | $37.15 |
Highmark BCBS Setting Professional Modifier None Typical Low $3.63 Median $4.47 Typical High $5.01 | Professional | None | $3.63 | $4.47 | $5.01 |
Independence Blue Cross Setting Facility Modifier None Typical Low $10.00 Median $53.70 Typical High $2,290.87 | Facility | None | $10.00 | $53.70 | $2,290.87 |
Independence Blue Cross Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Martin's Point Setting Facility Modifier None Typical Low $4.90 Median $13.80 Typical High $34.67 | Facility | None | $4.90 | $13.80 | $34.67 |
Martin's Point Setting Professional Modifier None Typical Low $4.90 Median $5.13 Typical High $8.32 | Professional | None | $4.90 | $5.13 | $8.32 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $2.45 Typical High $2.57 | Professional | 52 · Reduced service | $2.45 | $2.45 | $2.57 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $0.98 Typical High $1.02 | Professional | 53 · Discontinued | $0.98 | $0.98 | $1.02 |
UPMC Health Plan Setting Facility Modifier None Typical Low $6.03 Median $14.79 Typical High $27.54 | Facility | None | $6.03 | $14.79 | $27.54 |
UPMC Health Plan Setting Professional Modifier None Typical Low $5.25 Median $6.03 Typical High $8.51 | Professional | None | $5.25 | $6.03 | $8.51 |
United Setting Facility Modifier None Typical Low $2.00 Median $6.03 Typical High $15.14 | Facility | None | $2.00 | $6.03 | $15.14 |
United Setting Professional Modifier None Typical Low $2.69 Median $3.89 Typical High $10.47 | Professional | None | $2.69 | $3.89 | $10.47 |
2 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier 91 · Repeat lab test Typical Low $12.02 Median $23.44 Typical High $51.29 | Facility | 91 · Repeat lab test | $12.02 | $23.44 | $51.29 |
Highmark BCBS Setting Facility Modifier XU · Unusual separate service Typical Low $4.90 Median $14.45 Typical High $34.67 | Facility | XU · Unusual separate service | $4.90 | $14.45 | $34.67 |
Where Pennsylvania sits
The same service costs 14.5 times more in Minnesota 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· 18th of 51
$7.59
MN $64.57MD $4.47
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.