How much rates vary
Facilitymedian $26 · 10th to 90th $13 to $85Professionalmedian $14 · 10th to 90th $10 to $22
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 $13.49 Median $14.13 Typical High $69.18 | Facility | None | $13.49 | $14.13 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $13.49 Typical High $22.91 | Professional | None | $11.22 | $13.49 | $22.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.31 Median $6.76 Typical High $7.08 | Professional | 52 · Reduced service | $6.31 | $6.76 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.69 Typical High $2.82 | Professional | 53 · Discontinued | $2.51 | $2.69 | $2.82 |
AmeriHealth Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
AmeriHealth Setting Professional Modifier None Typical Low $9.12 Median $10.72 Typical High $11.75 | Professional | None | $9.12 | $10.72 | $11.75 |
Capital Blue Cross Setting Facility Modifier None Typical Low $63.10 Median $81.28 Typical High $5,011.87 | Facility | None | $63.10 | $81.28 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $14.13 | Professional | None | $12.88 | $12.88 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $10.96 Median $23.99 Typical High $50.12 | Facility | None | $10.96 | $23.99 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $15.49 Typical High $25.70 | Professional | None | $7.41 | $15.49 | $25.70 |
Emblem Health Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $23.99 | Professional | None | $7.76 | $7.76 | $23.99 |
Geisinger Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Geisinger Setting Professional Modifier None Typical Low $11.48 Median $14.13 Typical High $24.55 | Professional | None | $11.48 | $14.13 | $24.55 |
Highmark BCBS Setting Facility Modifier None Typical Low $34.67 Median $47.86 Typical High $74.13 | Facility | None | $34.67 | $47.86 | $74.13 |
Independence Blue Cross Setting Facility Modifier None Typical Low $16.60 Median $44.67 Typical High $1,122.02 | Facility | None | $16.60 | $44.67 | $1,122.02 |
Independence Blue Cross Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $11.75 | Professional | None | $10.72 | $10.72 | $11.75 |
Martin's Point Setting Facility Modifier None Typical Low $13.49 Median $14.13 Typical High $74.13 | Facility | None | $13.49 | $14.13 | $74.13 |
Martin's Point Setting Professional Modifier None Typical Low $12.02 Median $13.49 Typical High $22.91 | Professional | None | $12.02 | $13.49 | $22.91 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 52 · Reduced service | $6.76 | $6.76 | $7.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $2.82 | Professional | 53 · Discontinued | $2.69 | $2.69 | $2.82 |
UPMC Health Plan Setting Facility Modifier None Typical Low $25.12 Median $44.67 Typical High $79.43 | Facility | None | $25.12 | $44.67 | $79.43 |
UPMC Health Plan Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
United Setting Facility Modifier None Typical Low $14.79 Median $16.60 Typical High $19.95 | Facility | None | $14.79 | $16.60 | $19.95 |
United Setting Professional Modifier None Typical Low $10.00 Median $14.13 Typical High $17.38 | Professional | None | $10.00 | $14.13 | $17.38 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $7.08 Median $8.32 Typical High $27.54 | Professional | QW · Waived lab test | $7.08 | $8.32 | $27.54 |
Highmark BCBS Setting Professional Modifier 51 · Multiple procedures + 59 · Distinct service + 76 · Repeat, same provider + QW · Waived lab test + SA · Nurse practitioner + XU · Unusual separate service Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 51 · Multiple procedures + 59 · Distinct service + 76 · Repeat, same provider + QW · Waived lab test + SA · Nurse practitioner + XU · Unusual separate service | $12.30 | $12.30 | $12.30 |
Where Pennsylvania sits
The same service costs 3.2 times more in Alaska than in New Jersey. 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· 42nd of 51
$14.13
AK $37.15NJ $11.48
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.