How much rates vary
Facilitymedian $30 · 10th to 90th $10 to $78Professionalmedian $10 · 10th to 90th $7 to $17
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 $9.77 Median $20.42 Typical High $56.23 | Facility | None | $9.77 | $20.42 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $10.23 Typical High $15.85 | Professional | None | $9.33 | $10.23 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.79 Median $4.90 Typical High $5.37 | Professional | 52 · Reduced service | $4.79 | $4.90 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.95 Typical High $2.14 | Professional | 53 · Discontinued | $1.91 | $1.95 | $2.14 |
Ambetter Setting Professional Modifier None Typical Low $7.24 Median $12.02 Typical High $12.02 | Professional | None | $7.24 | $12.02 | $12.02 |
AmeriHealth Setting Facility Modifier None Typical Low $20.42 Median $57.54 Typical High $954.99 | Facility | None | $20.42 | $57.54 | $954.99 |
AmeriHealth Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $19.95 | Professional | None | $7.94 | $7.94 | $19.95 |
Capital Blue Cross Setting Facility Modifier None Typical Low $69.18 Median $89.13 Typical High $5,011.87 | Facility | None | $69.18 | $89.13 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $12.02 | Professional | None | $9.33 | $9.33 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $18.20 Typical High $36.31 | Facility | None | $8.51 | $18.20 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $13.49 Typical High $29.51 | Professional | None | $7.59 | $13.49 | $29.51 |
Emblem Health Setting Professional Modifier None Typical Low $5.25 Median $5.62 Typical High $17.38 | Professional | None | $5.25 | $5.62 | $17.38 |
Geisinger Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Geisinger Setting Professional Modifier None Typical Low $10.23 Median $13.49 Typical High $18.20 | Professional | None | $10.23 | $13.49 | $18.20 |
Highmark BCBS Setting Facility Modifier None Typical Low $16.98 Median $32.36 Typical High $60.26 | Facility | None | $16.98 | $32.36 | $60.26 |
Highmark BCBS Setting Professional Modifier None Typical Low $7.24 Median $9.12 Typical High $19.95 | Professional | None | $7.24 | $9.12 | $19.95 |
Independence Blue Cross Setting Facility Modifier None Typical Low $16.98 Median $52.48 Typical High $831.76 | Facility | None | $16.98 | $52.48 | $831.76 |
Independence Blue Cross Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Martin's Point Setting Facility Modifier None Typical Low $9.77 Median $22.91 Typical High $56.23 | Facility | None | $9.77 | $22.91 | $56.23 |
Martin's Point Setting Professional Modifier None Typical Low $9.55 Median $10.00 Typical High $15.85 | Professional | None | $9.55 | $10.00 | $15.85 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $4.90 Median $4.90 Typical High $5.13 | Professional | 52 · Reduced service | $4.90 | $4.90 | $5.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $1.95 Typical High $2.04 | Professional | 53 · Discontinued | $1.95 | $1.95 | $2.04 |
UPMC Health Plan Setting Facility Modifier None Typical Low $12.02 Median $30.20 Typical High $63.10 | Facility | None | $12.02 | $30.20 | $63.10 |
UPMC Health Plan Setting Professional Modifier None Typical Low $10.72 Median $12.02 Typical High $17.38 | Professional | None | $10.72 | $12.02 | $17.38 |
United Setting Facility Modifier None Typical Low $10.96 Median $12.02 Typical High $14.45 | Facility | None | $10.96 | $12.02 | $14.45 |
United Setting Professional Modifier None Typical Low $5.50 Median $7.94 Typical High $20.89 | Professional | None | $5.50 | $7.94 | $20.89 |
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 $10.00 Median $30.90 Typical High $75.86 | Facility | PN · Off-campus dept, non-excepted | $10.00 | $30.90 | $75.86 |
Where Pennsylvania sits
The same service costs 8.3 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
$15.85
VT $75.86MD $9.12
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.