How much rates vary
Facilitymedian $81 · 10th to 90th $45 to $1,072Professionalmedian $65 · 10th to 90th $50 to $85
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 $50.12 Median $72.44 Typical High $354.81 | Facility | None | $50.12 | $72.44 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $75.86 | Professional | None | $54.95 | $64.57 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $87.10 | Professional | None | $51.29 | $66.07 | $87.10 |
AmeriHealth Setting Facility Modifier None Typical Low $70.79 Median $436.52 Typical High $1,949.84 | Facility | None | $70.79 | $436.52 | $1,949.84 |
AmeriHealth Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $77.62 | Professional | None | $52.48 | $66.07 | $77.62 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $114.82 | Professional | None | $81.28 | $85.11 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $72.44 | Professional | None | $36.31 | $46.77 | $72.44 |
Emblem Health Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $60.26 | Facility | None | $30.20 | $30.20 | $60.26 |
Emblem Health Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $50.12 | Professional | None | $30.20 | $34.67 | $50.12 |
Geisinger Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $50.12 | Facility | None | $44.67 | $44.67 | $50.12 |
Geisinger Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $147.91 | Professional | None | $63.10 | $83.18 | $147.91 |
Highmark BCBS Setting Facility Modifier None Typical Low $79.43 Median $114.82 Typical High $741.31 | Facility | None | $79.43 | $114.82 | $741.31 |
Highmark BCBS Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $91.20 | Professional | None | $61.66 | $67.61 | $91.20 |
Independence Blue Cross Setting Facility Modifier None Typical Low $70.79 Median $478.63 Typical High $1,905.46 | Facility | None | $70.79 | $478.63 | $1,905.46 |
Independence Blue Cross Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $77.62 | Professional | None | $52.48 | $66.07 | $77.62 |
Martin's Point Setting Facility Modifier None Typical Low $47.86 Median $72.44 Typical High $354.81 | Facility | None | $47.86 | $72.44 | $354.81 |
Martin's Point Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $75.86 | Professional | None | $54.95 | $64.57 | $75.86 |
Optum Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $75.86 | Professional | None | $56.23 | $56.23 | $75.86 |
Oscar Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Oscar Health Setting Professional Modifier None Typical Low $34.67 Median $56.23 Typical High $75.86 | Professional | None | $34.67 | $56.23 | $75.86 |
UPMC Health Plan Setting Facility Modifier None Typical Low $45.71 Median $57.54 Typical High $74.13 | Facility | None | $45.71 | $57.54 | $74.13 |
UPMC Health Plan Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $70.79 | Professional | None | $45.71 | $45.71 | $70.79 |
United Setting Facility Modifier None Typical Low $245.47 Median $524.81 Typical High $602.56 | Facility | None | $245.47 | $524.81 | $602.56 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $79.43 | Professional | None | $56.23 | $56.23 | $79.43 |
22 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 |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $74.13 Median $75.86 Typical High $79.43 | Facility | AF · Specialist physician | $74.13 | $75.86 | $79.43 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $54.95 Median $56.23 Typical High $58.88 | Facility | HO · Master's level | $54.95 | $56.23 | $58.88 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $63.10 Median $64.57 Typical High $67.61 | Facility | TD · Registered nurse | $63.10 | $64.57 | $67.61 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $50.12 Median $54.95 Typical High $87.10 | Professional | AF · Specialist physician | $50.12 | $54.95 | $87.10 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $54.95 Median $56.23 Typical High $97.72 | Professional | HO · Master's level | $54.95 | $56.23 | $97.72 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $63.10 Median $64.57 Typical High $109.65 | Professional | TD · Registered nurse | $63.10 | $64.57 | $109.65 |
Ambetter Setting Professional Modifier HE · Mental health program Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | HE · Mental health program | $44.67 | $44.67 | $44.67 |
Ambetter Setting Professional Modifier HO · Master's level Typical Low $60.26 Median $100.00 Typical High $128.82 | Professional | HO · Master's level | $60.26 | $100.00 | $128.82 |
Emblem Health Setting Professional Modifier HG · Opioid treatment program Typical Low $32.36 Median $44.67 Typical High $44.67 | Professional | HG · Opioid treatment program | $32.36 | $44.67 | $44.67 |
Highmark BCBS Setting Professional Modifier 93 · Audio-only telehealth Typical Low $61.66 Median $63.10 Typical High $87.10 | Professional | 93 · Audio-only telehealth | $61.66 | $63.10 | $87.10 |
Highmark BCBS Setting Professional Modifier AM · Physician, team member Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | AM · Physician, team member | $81.28 | $81.28 | $87.10 |
Highmark BCBS Setting Professional Modifier FQ · Audio-only Typical Low $70.79 Median $81.28 Typical High $87.10 | Professional | FQ · Audio-only | $70.79 | $81.28 | $87.10 |
Highmark BCBS Setting Professional Modifier HE · Mental health program Typical Low $53.70 Median $61.66 Typical High $75.86 | Professional | HE · Mental health program | $53.70 | $61.66 | $75.86 |
Highmark BCBS Setting Professional Modifier HO · Master's level Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | HO · Master's level | $61.66 | $63.10 | $63.10 |
Highmark BCBS Setting Professional Modifier SA · Nurse practitioner Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | SA · Nurse practitioner | $66.07 | $66.07 | $66.07 |
Highmark BCBS Setting Professional Modifier SE · Publicly funded program Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | SE · Publicly funded program | $61.66 | $61.66 | $61.66 |
Martin's Point Setting Facility Modifier AF · Specialist physician Typical Low $74.13 Median $75.86 Typical High $79.43 | Facility | AF · Specialist physician | $74.13 | $75.86 | $79.43 |
Martin's Point Setting Facility Modifier HO · Master's level Typical Low $54.95 Median $56.23 Typical High $58.88 | Facility | HO · Master's level | $54.95 | $56.23 | $58.88 |
Martin's Point Setting Facility Modifier TD · Registered nurse Typical Low $63.10 Median $64.57 Typical High $67.61 | Facility | TD · Registered nurse | $63.10 | $64.57 | $67.61 |
Martin's Point Setting Professional Modifier AF · Specialist physician Typical Low $50.12 Median $54.95 Typical High $87.10 | Professional | AF · Specialist physician | $50.12 | $54.95 | $87.10 |
Martin's Point Setting Professional Modifier HO · Master's level Typical Low $54.95 Median $56.23 Typical High $97.72 | Professional | HO · Master's level | $54.95 | $56.23 | $97.72 |
Martin's Point Setting Professional Modifier TD · Registered nurse Typical Low $63.10 Median $64.57 Typical High $109.65 | Professional | TD · Registered nurse | $63.10 | $64.57 | $109.65 |
Where Pennsylvania sits
The same service costs 1.9 times more in North Dakota than in Kentucky. 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· 28th of 51
$64.57
ND $100KY $53.70
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.