How much rates vary
Facilitymedian $54 · 10th to 90th $19 to $138Professionalmedian $19 · 10th to 90th $13 to $41
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 $18.20 Median $34.67 Typical High $79.43 | Facility | None | $18.20 | $34.67 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $19.05 Typical High $30.90 | Professional | None | $17.78 | $19.05 | $30.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $9.12 Typical High $10.00 | Professional | 52 · Reduced service | $8.91 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.63 Typical High $3.98 | Professional | 53 · Discontinued | $3.55 | $3.63 | $3.98 |
Ambetter Setting Professional Modifier None Typical Low $13.80 Median $22.39 Typical High $22.39 | Professional | None | $13.80 | $22.39 | $22.39 |
AmeriHealth Setting Facility Modifier None Typical Low $42.66 Median $107.15 Typical High $851.14 | Facility | None | $42.66 | $107.15 | $851.14 |
Capital Blue Cross Setting Facility Modifier None Typical Low $128.82 Median $165.96 Typical High $5,011.87 | Facility | None | $128.82 | $165.96 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $23.44 | Professional | None | $17.38 | $17.38 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $15.49 Median $33.88 Typical High $67.61 | Facility | None | $15.49 | $33.88 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $26.92 Typical High $64.57 | Professional | None | $19.05 | $26.92 | $64.57 |
Emblem Health Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $32.36 | Professional | None | $10.47 | $10.47 | $32.36 |
Geisinger Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Geisinger Setting Professional Modifier None Typical Low $19.05 Median $25.12 Typical High $33.88 | Professional | None | $19.05 | $25.12 | $33.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $30.20 Median $58.88 Typical High $104.71 | Facility | None | $30.20 | $58.88 | $104.71 |
Highmark BCBS Setting Professional Modifier None Typical Low $15.14 Median $16.60 Typical High $18.62 | Professional | None | $15.14 | $16.60 | $18.62 |
Independence Blue Cross Setting Facility Modifier None Typical Low $42.66 Median $97.72 Typical High $218.78 | Facility | None | $42.66 | $97.72 | $218.78 |
Martin's Point Setting Facility Modifier None Typical Low $18.20 Median $38.02 Typical High $79.43 | Facility | None | $18.20 | $38.02 | $79.43 |
Martin's Point Setting Professional Modifier None Typical Low $18.20 Median $19.05 Typical High $30.90 | Professional | None | $18.20 | $19.05 | $30.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $9.12 Typical High $9.55 | Professional | 52 · Reduced service | $9.12 | $9.12 | $9.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.80 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $22.39 Median $54.95 Typical High $144.54 | Facility | None | $22.39 | $54.95 | $144.54 |
UPMC Health Plan Setting Professional Modifier None Typical Low $19.50 Median $22.39 Typical High $31.62 | Professional | None | $19.50 | $22.39 | $31.62 |
United Setting Facility Modifier None Typical Low $19.95 Median $22.39 Typical High $26.92 | Facility | None | $19.95 | $22.39 | $26.92 |
United Setting Professional Modifier None Typical Low $9.33 Median $14.45 Typical High $36.31 | Professional | None | $9.33 | $14.45 | $36.31 |
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 $10.72 Median $47.86 Typical High $131.83 | Facility | PN · Off-campus dept, non-excepted | $10.72 | $47.86 | $131.83 |
Where Pennsylvania sits
The same service costs 4.8 times more in Minnesota than in Alabama. 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
$28.84
MN $72.44AL $15.14
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.