How much rates vary
Facilitymedian $14 · 10th to 90th $5 to $39Professionalmedian $5 · 10th to 90th $3 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 $4.57 Median $8.71 Typical High $30.90 | Facility | None | $4.57 | $8.71 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $4.68 Typical High $7.41 | Professional | None | $4.37 | $4.68 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $2.29 Typical High $2.51 | Professional | 52 · Reduced service | $2.24 | $2.29 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.91 Typical High $1.02 | Professional | 53 · Discontinued | $0.89 | $0.91 | $1.02 |
Ambetter Setting Professional Modifier None Typical Low $3.39 Median $5.62 Typical High $5.62 | Professional | None | $3.39 | $5.62 | $5.62 |
AmeriHealth Setting Facility Modifier None Typical Low $9.55 Median $26.30 Typical High $371.54 | Facility | None | $9.55 | $26.30 | $371.54 |
AmeriHealth Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $9.33 | Professional | None | $3.72 | $3.72 | $9.33 |
Capital Blue Cross Setting Facility Modifier None Typical Low $32.36 Median $41.69 Typical High $5,011.87 | Facility | None | $32.36 | $41.69 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.62 | Professional | None | $4.47 | $4.47 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $8.71 Typical High $16.98 | Facility | None | $3.98 | $8.71 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $6.46 Typical High $13.80 | Professional | None | $3.55 | $6.46 | $13.80 |
Emblem Health Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $8.13 | Professional | None | $2.63 | $2.63 | $8.13 |
Geisinger Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Geisinger Setting Professional Modifier None Typical Low $4.79 Median $6.31 Typical High $8.51 | Professional | None | $4.79 | $6.31 | $8.51 |
Highmark BCBS Setting Facility Modifier None Typical Low $8.32 Median $15.85 Typical High $34.67 | Facility | None | $8.32 | $15.85 | $34.67 |
Highmark BCBS Setting Professional Modifier None Typical Low $3.39 Median $4.27 Typical High $9.33 | Professional | None | $3.39 | $4.27 | $9.33 |
Independence Blue Cross Setting Facility Modifier None Typical Low $7.94 Median $23.44 Typical High $53.70 | Facility | None | $7.94 | $23.44 | $53.70 |
Independence Blue Cross Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Martin's Point Setting Facility Modifier None Typical Low $4.57 Median $8.71 Typical High $31.62 | Facility | None | $4.57 | $8.71 | $31.62 |
Martin's Point Setting Professional Modifier None Typical Low $4.47 Median $4.68 Typical High $7.41 | Professional | None | $4.47 | $4.68 | $7.41 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2.29 Median $2.29 Typical High $2.40 | Professional | 52 · Reduced service | $2.29 | $2.29 | $2.40 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $0.91 Typical High $0.95 | Professional | 53 · Discontinued | $0.91 | $0.91 | $0.95 |
UPMC Health Plan Setting Facility Modifier None Typical Low $5.62 Median $20.42 Typical High $42.66 | Facility | None | $5.62 | $20.42 | $42.66 |
UPMC Health Plan Setting Professional Modifier None Typical Low $5.01 Median $5.62 Typical High $8.13 | Professional | None | $5.01 | $5.62 | $8.13 |
United Setting Facility Modifier None Typical Low $5.13 Median $5.62 Typical High $6.76 | Facility | None | $5.13 | $5.62 | $6.76 |
United Setting Professional Modifier None Typical Low $2.51 Median $4.17 Typical High $9.77 | Professional | None | $2.51 | $4.17 | $9.77 |
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 $2.69 Median $13.18 Typical High $51.29 | Facility | PN · Off-campus dept, non-excepted | $2.69 | $13.18 | $51.29 |
Where Pennsylvania sits
The same service costs 13.5 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· 15th of 51
$7.24
VT $57.54MD $4.27
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.