How much rates vary
Facilitymedian $43 · 10th to 90th $14 to $107Professionalmedian $14 · 10th to 90th $9 to $25
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 $13.80 Median $28.84 Typical High $89.13 | Facility | None | $13.80 | $28.84 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $13.80 Typical High $21.38 | Professional | None | $13.49 | $13.80 | $21.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $6.92 Typical High $7.59 | Professional | 52 · Reduced service | $6.76 | $6.92 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.75 Typical High $3.02 | Professional | 53 · Discontinued | $2.69 | $2.75 | $3.02 |
Ambetter Setting Professional Modifier None Typical Low $10.47 Median $16.98 Typical High $16.98 | Professional | None | $10.47 | $16.98 | $16.98 |
AmeriHealth Setting Facility Modifier None Typical Low $26.30 Median $74.13 Typical High $549.54 | Facility | None | $26.30 | $74.13 | $549.54 |
AmeriHealth Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $28.18 | Professional | None | $10.96 | $10.96 | $28.18 |
Capital Blue Cross Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $5,011.87 | Facility | None | $97.72 | $125.89 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $16.98 | Professional | None | $13.18 | $13.18 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $12.02 Median $25.70 Typical High $51.29 | Facility | None | $12.02 | $25.70 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $17.78 Typical High $41.69 | Professional | None | $10.72 | $17.78 | $41.69 |
Emblem Health Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $24.55 | Professional | None | $7.94 | $7.94 | $24.55 |
Geisinger Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Geisinger Setting Professional Modifier None Typical Low $14.45 Median $19.05 Typical High $25.70 | Professional | None | $14.45 | $19.05 | $25.70 |
Highmark BCBS Setting Facility Modifier None Typical Low $25.12 Median $45.71 Typical High $97.72 | Facility | None | $25.12 | $45.71 | $97.72 |
Highmark BCBS Setting Professional Modifier None Typical Low $10.23 Median $12.88 Typical High $14.45 | Professional | None | $10.23 | $12.88 | $14.45 |
Independence Blue Cross Setting Facility Modifier None Typical Low $23.99 Median $66.07 Typical High $151.36 | Facility | None | $23.99 | $66.07 | $151.36 |
Independence Blue Cross Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Martin's Point Setting Facility Modifier None Typical Low $13.80 Median $35.48 Typical High $95.50 | Facility | None | $13.80 | $35.48 | $95.50 |
Martin's Point Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $16.22 | Professional | None | $13.80 | $13.80 | $16.22 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.92 Median $6.92 Typical High $7.24 | Professional | 52 · Reduced service | $6.92 | $6.92 | $7.24 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $2.88 | Professional | 53 · Discontinued | $2.75 | $2.75 | $2.88 |
UPMC Health Plan Setting Facility Modifier None Typical Low $38.90 Median $54.95 Typical High $97.72 | Facility | None | $38.90 | $54.95 | $97.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
United Setting Facility Modifier None Typical Low $15.49 Median $16.98 Typical High $20.42 | Facility | None | $15.49 | $16.98 | $20.42 |
United Setting Professional Modifier None Typical Low $7.08 Median $10.96 Typical High $29.51 | Professional | None | $7.08 | $10.96 | $29.51 |
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 PN · Off-campus dept, non-excepted Typical Low $8.13 Median $36.31 Typical High $102.33 | Facility | PN · Off-campus dept, non-excepted | $8.13 | $36.31 | $102.33 |
Highmark BCBS Setting Facility Modifier XU · Unusual separate service Typical Low $23.99 Median $54.95 Typical High $114.82 | Facility | XU · Unusual separate service | $23.99 | $54.95 | $114.82 |
Where Pennsylvania sits
The same service costs 8.1 times more in Vermont than in Indiana. 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· 11th of 51
$23.44
VT $105IN $12.88
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.