How much rates vary
Facilitymedian $123 · 10th to 90th $102 to $295Professionalmedian $126 · 10th to 90th $102 to $141
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 $102.33 Median $123.03 Typical High $144.54 | Facility | None | $102.33 | $123.03 | $144.54 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $50.12 Median $61.66 Typical High $69.18 | Facility | 52 · Reduced service | $50.12 | $61.66 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.95 Median $24.55 Typical High $27.54 | Facility | 53 · Discontinued | $19.95 | $24.55 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $138.04 | Professional | None | $102.33 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $54.95 Typical High $69.18 | Professional | 52 · Reduced service | $50.12 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $27.54 | Professional | 53 · Discontinued | $19.95 | $21.88 | $27.54 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $194.98 | Professional | None | $89.13 | $123.03 | $194.98 |
AmeriHealth Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | None | $107.15 | $107.15 | $134.90 |
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 $128.82 Median $134.90 Typical High $186.21 | Professional | None | $128.82 | $134.90 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $141.25 | Professional | None | $91.20 | $134.90 | $141.25 |
Emblem Health Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Emblem Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $120.23 | Professional | None | $50.12 | $50.12 | $120.23 |
Geisinger Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $120.23 | Facility | None | $109.65 | $109.65 | $120.23 |
Geisinger Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $251.19 | Professional | None | $91.20 | $125.89 | $251.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $309.03 Median $1,047.13 Typical High $1,949.84 | Facility | None | $309.03 | $1,047.13 | $1,949.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $162.18 | Professional | None | $123.03 | $138.04 | $162.18 |
Independence Blue Cross Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $134.90 | Professional | None | $107.15 | $134.90 | $134.90 |
Martin's Point Setting Facility Modifier None Typical Low $102.33 Median $123.03 Typical High $144.54 | Facility | None | $102.33 | $123.03 | $144.54 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $50.12 Median $61.66 Typical High $69.18 | Facility | 52 · Reduced service | $50.12 | $61.66 | $69.18 |
Martin's Point Setting Facility Modifier 53 · Discontinued Typical Low $19.95 Median $24.55 Typical High $27.54 | Facility | 53 · Discontinued | $19.95 | $24.55 | $27.54 |
Martin's Point Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $138.04 | Professional | None | $102.33 | $117.49 | $138.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $54.95 Typical High $69.18 | Professional | 52 · Reduced service | $50.12 | $54.95 | $69.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $27.54 | Professional | 53 · Discontinued | $19.95 | $21.88 | $27.54 |
Optum Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $138.04 | Professional | None | $128.82 | $128.82 | $138.04 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $151.36 | Professional | None | $109.65 | $128.82 | $151.36 |
UPMC Health Plan Setting Facility Modifier None Typical Low $104.71 Median $144.54 Typical High $229.09 | Facility | None | $104.71 | $144.54 | $229.09 |
UPMC Health Plan Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $154.88 | Professional | None | $104.71 | $141.25 | $154.88 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,096.48 Typical High $1,258.93 | Facility | None | $512.86 | $1,096.48 | $1,258.93 |
United Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $169.82 | Professional | None | $104.71 | $128.82 | $169.82 |
13 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 $138.04 Median $138.04 Typical High $151.36 | Facility | AF · Specialist physician | $138.04 | $138.04 | $151.36 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $102.33 Median $104.71 Typical High $112.20 | Facility | HO · Master's level | $102.33 | $104.71 | $112.20 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $117.49 Median $117.49 Typical High $128.82 | Facility | TD · Registered nurse | $117.49 | $117.49 | $128.82 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $138.04 Median $144.54 Typical High $190.55 | Professional | AF · Specialist physician | $138.04 | $144.54 | $190.55 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $102.33 Median $107.15 Typical High $141.25 | Professional | HO · Master's level | $102.33 | $107.15 | $141.25 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $117.49 Median $123.03 Typical High $162.18 | Professional | TD · Registered nurse | $117.49 | $123.03 | $162.18 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | 59 · Distinct service | $128.82 | $138.04 | $138.04 |
Martin's Point Setting Facility Modifier AF · Specialist physician Typical Low $138.04 Median $138.04 Typical High $151.36 | Facility | AF · Specialist physician | $138.04 | $138.04 | $151.36 |
Martin's Point Setting Facility Modifier HO · Master's level Typical Low $102.33 Median $104.71 Typical High $112.20 | Facility | HO · Master's level | $102.33 | $104.71 | $112.20 |
Martin's Point Setting Facility Modifier TD · Registered nurse Typical Low $117.49 Median $117.49 Typical High $128.82 | Facility | TD · Registered nurse | $117.49 | $117.49 | $128.82 |
Martin's Point Setting Professional Modifier AF · Specialist physician Typical Low $138.04 Median $144.54 Typical High $190.55 | Professional | AF · Specialist physician | $138.04 | $144.54 | $190.55 |
Martin's Point Setting Professional Modifier HO · Master's level Typical Low $102.33 Median $107.15 Typical High $141.25 | Professional | HO · Master's level | $102.33 | $107.15 | $141.25 |
Martin's Point Setting Professional Modifier TD · Registered nurse Typical Low $117.49 Median $123.03 Typical High $162.18 | Professional | TD · Registered nurse | $117.49 | $123.03 | $162.18 |
Where Pennsylvania sits
The same service costs 2.3 times more in Alaska 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· 25th of 51
$126
AK $224KY $95.50
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.