How much rates vary
Facilitymedian $38 · 10th to 90th $32 to $977Professionalmedian $35 · 10th to 90th $28 to $44
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 $31.62 Median $36.31 Typical High $43.65 | Facility | None | $31.62 | $36.31 | $43.65 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $15.85 Median $17.78 Typical High $19.95 | Facility | 52 · Reduced service | $15.85 | $17.78 | $19.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.31 Median $7.08 Typical High $7.94 | Facility | 53 · Discontinued | $6.31 | $7.08 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $32.36 Typical High $43.65 | Professional | None | $28.18 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $16.22 Typical High $19.05 | Professional | 52 · Reduced service | $15.85 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.46 Typical High $7.59 | Professional | 53 · Discontinued | $6.31 | $6.46 | $7.59 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $34.67 Typical High $35.48 | Professional | None | $25.12 | $34.67 | $35.48 |
AmeriHealth Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $38.90 | Professional | None | $28.84 | $38.90 | $38.90 |
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 $33.11 Median $34.67 Typical High $46.77 | Professional | None | $33.11 | $34.67 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $40.74 | Professional | None | $25.70 | $38.90 | $40.74 |
Emblem Health Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Emblem Health Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $34.67 | Professional | None | $14.45 | $14.45 | $34.67 |
Geisinger Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $39.81 | Facility | None | $36.31 | $36.31 | $39.81 |
Geisinger Setting Professional Modifier None Typical Low $26.92 Median $38.02 Typical High $75.86 | Professional | None | $26.92 | $38.02 | $75.86 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,905.46 | Facility | None | $1,862.09 | $1,862.09 | $1,905.46 |
Highmark BCBS Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $44.67 | Professional | None | $28.18 | $37.15 | $44.67 |
Independence Blue Cross Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $38.90 | Professional | None | $28.84 | $38.90 | $38.90 |
Martin's Point Setting Facility Modifier None Typical Low $31.62 Median $36.31 Typical High $43.65 | Facility | None | $31.62 | $36.31 | $43.65 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $15.85 Median $16.98 Typical High $19.95 | Facility | 52 · Reduced service | $15.85 | $16.98 | $19.95 |
Martin's Point Setting Facility Modifier 53 · Discontinued Typical Low $6.31 Median $6.76 Typical High $7.94 | Facility | 53 · Discontinued | $6.31 | $6.76 | $7.94 |
Martin's Point Setting Professional Modifier None Typical Low $28.18 Median $32.36 Typical High $42.66 | Professional | None | $28.18 | $32.36 | $42.66 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $16.22 Typical High $19.05 | Professional | 52 · Reduced service | $15.85 | $16.22 | $19.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.46 Typical High $7.59 | Professional | 53 · Discontinued | $6.31 | $6.46 | $7.59 |
Optum Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Professional | None | $33.88 | $33.88 | $36.31 |
Oscar Health Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $43.65 | Professional | None | $32.36 | $33.88 | $43.65 |
UPMC Health Plan Setting Facility Modifier None Typical Low $31.62 Median $109.65 Typical High $173.78 | Facility | None | $31.62 | $109.65 | $173.78 |
UPMC Health Plan Setting Professional Modifier None Typical Low $31.62 Median $39.81 Typical High $43.65 | Professional | None | $31.62 | $39.81 | $43.65 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,318.26 Typical High $1,513.56 | Facility | None | $616.60 | $1,318.26 | $1,513.56 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $43.65 | Professional | None | $33.88 | $33.88 | $43.65 |
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 $37.15 Median $39.81 Typical High $45.71 | Facility | AF · Specialist physician | $37.15 | $39.81 | $45.71 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $28.18 Median $29.51 Typical High $33.88 | Facility | HO · Master's level | $28.18 | $29.51 | $33.88 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $31.62 Median $33.88 Typical High $38.90 | Facility | TD · Registered nurse | $31.62 | $33.88 | $38.90 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $37.15 Median $43.65 Typical High $64.57 | Professional | AF · Specialist physician | $37.15 | $43.65 | $64.57 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $28.18 Median $32.36 Typical High $48.98 | Professional | HO · Master's level | $28.18 | $32.36 | $48.98 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $31.62 Median $36.31 Typical High $54.95 | Professional | TD · Registered nurse | $31.62 | $36.31 | $54.95 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service Typical Low $34.67 Median $37.15 Typical High $39.81 | Professional | 59 · Distinct service | $34.67 | $37.15 | $39.81 |
Martin's Point Setting Facility Modifier AF · Specialist physician Typical Low $37.15 Median $39.81 Typical High $45.71 | Facility | AF · Specialist physician | $37.15 | $39.81 | $45.71 |
Martin's Point Setting Facility Modifier HO · Master's level Typical Low $28.18 Median $29.51 Typical High $33.88 | Facility | HO · Master's level | $28.18 | $29.51 | $33.88 |
Martin's Point Setting Facility Modifier TD · Registered nurse Typical Low $31.62 Median $33.88 Typical High $38.90 | Facility | TD · Registered nurse | $31.62 | $33.88 | $38.90 |
Martin's Point Setting Professional Modifier AF · Specialist physician Typical Low $37.15 Median $43.65 Typical High $64.57 | Professional | AF · Specialist physician | $37.15 | $43.65 | $64.57 |
Martin's Point Setting Professional Modifier HO · Master's level Typical Low $28.18 Median $32.36 Typical High $48.98 | Professional | HO · Master's level | $28.18 | $32.36 | $48.98 |
Martin's Point Setting Professional Modifier TD · Registered nurse Typical Low $31.62 Median $36.31 Typical High $54.95 | Professional | TD · Registered nurse | $31.62 | $36.31 | $54.95 |
Where Pennsylvania sits
The same service costs 2.1 times more in North Dakota than in Ohio. 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· 37th of 51
$34.67
ND $54.95OH $26.30
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.