How much rates vary
Facilitymedian $22 · 10th to 90th $7 to $60Professionalmedian $7 · 10th to 90th $5 to $13
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 $7.08 Median $19.95 Typical High $60.26 | Facility | None | $7.08 | $19.95 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $7.41 Typical High $11.22 | Professional | None | $6.76 | $7.41 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.39 Median $3.55 Typical High $3.89 | Professional | 52 · Reduced service | $3.39 | $3.55 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.41 Typical High $1.55 | Professional | 53 · Discontinued | $1.38 | $1.41 | $1.55 |
Ambetter Setting Professional Modifier None Typical Low $5.25 Median $8.71 Typical High $8.71 | Professional | None | $5.25 | $8.71 | $8.71 |
AmeriHealth Setting Facility Modifier None Typical Low $14.13 Median $45.71 Typical High $3,467.37 | Facility | None | $14.13 | $45.71 | $3,467.37 |
AmeriHealth Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $14.13 | Professional | None | $5.62 | $5.62 | $14.13 |
Capital Blue Cross Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $5,011.87 | Facility | None | $48.98 | $64.57 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $8.51 | Professional | None | $6.76 | $6.76 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $6.03 Median $13.18 Typical High $26.30 | Facility | None | $6.03 | $13.18 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $10.00 Typical High $20.89 | Professional | None | $5.50 | $10.00 | $20.89 |
Emblem Health Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $12.59 | Professional | None | $4.07 | $4.07 | $12.59 |
Geisinger Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Geisinger Setting Professional Modifier None Typical Low $7.41 Median $9.55 Typical High $12.88 | Professional | None | $7.41 | $9.55 | $12.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $13.49 Median $24.55 Typical High $57.54 | Facility | None | $13.49 | $24.55 | $57.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $5.25 Median $5.89 Typical High $14.13 | Professional | None | $5.25 | $5.89 | $14.13 |
Independence Blue Cross Setting Facility Modifier None Typical Low $8.71 Median $34.67 Typical High $3,467.37 | Facility | None | $8.71 | $34.67 | $3,467.37 |
Independence Blue Cross Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Martin's Point Setting Facility Modifier None Typical Low $7.08 Median $20.89 Typical High $60.26 | Facility | None | $7.08 | $20.89 | $60.26 |
Martin's Point Setting Professional Modifier None Typical Low $6.92 Median $7.41 Typical High $11.48 | Professional | None | $6.92 | $7.41 | $11.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $3.55 Median $3.55 Typical High $3.72 | Professional | 52 · Reduced service | $3.55 | $3.55 | $3.72 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.41 Typical High $1.48 | Professional | 53 · Discontinued | $1.41 | $1.41 | $1.48 |
Oscar Health Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
UPMC Health Plan Setting Facility Modifier None Typical Low $8.71 Median $21.38 Typical High $42.66 | Facility | None | $8.71 | $21.38 | $42.66 |
UPMC Health Plan Setting Professional Modifier None Typical Low $7.59 Median $8.71 Typical High $12.30 | Professional | None | $7.59 | $8.71 | $12.30 |
United Setting Facility Modifier None Typical Low $2.95 Median $8.71 Typical High $44.67 | Facility | None | $2.95 | $8.71 | $44.67 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.62 Typical High $15.14 | Professional | None | $3.89 | $5.62 | $15.14 |
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 XU · Unusual separate service Typical Low $12.30 Median $23.99 Typical High $63.10 | Facility | XU · Unusual separate service | $12.30 | $23.99 | $63.10 |
Where Pennsylvania sits
The same service costs 13.2 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· 16th of 51
$11.22
VT $85.11MD $6.46
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.