How much rates vary
Facilitymedian $158 · 10th to 90th $17 to $1,585Professionalmedian $18 · 10th to 90th $13 to $30
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 $15.14 Median $144.54 Typical High $501.19 | Facility | None | $15.14 | $144.54 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $15.14 Typical High $28.18 | Professional | None | $13.18 | $15.14 | $28.18 |
Ambetter Setting Professional Modifier None Typical Low $12.88 Median $16.22 Typical High $28.84 | Professional | None | $12.88 | $16.22 | $28.84 |
AmeriHealth Setting Facility Modifier None Typical Low $14.79 Median $1,122.02 Typical High $2,238.72 | Facility | None | $14.79 | $1,122.02 | $2,238.72 |
AmeriHealth Setting Professional Modifier None Typical Low $12.59 Median $19.50 Typical High $23.44 | Professional | None | $12.59 | $19.50 | $23.44 |
Capital Blue Cross Setting Facility Modifier None Typical Low $208.93 Median $5,011.87 Typical High $56,234.13 | Facility | None | $208.93 | $5,011.87 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $56,234.13 | Professional | None | $14.79 | $14.79 | $56,234.13 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $158.49 Typical High $190.55 | Facility | None | $74.13 | $158.49 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $24.55 Typical High $40.74 | Professional | None | $13.18 | $24.55 | $40.74 |
Emblem Health Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Geisinger Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $23.99 | Facility | None | $19.95 | $19.95 | $23.99 |
Geisinger Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $26.30 | Professional | None | $21.88 | $21.88 | $26.30 |
Highmark BCBS Setting Facility Modifier None Typical Low $97.72 Median $158.49 Typical High $263.03 | Facility | None | $97.72 | $158.49 | $263.03 |
Independence Blue Cross Setting Facility Modifier None Typical Low $14.79 Median $1,023.29 Typical High $2,344.23 | Facility | None | $14.79 | $1,023.29 | $2,344.23 |
Independence Blue Cross Setting Professional Modifier None Typical Low $14.79 Median $22.91 Typical High $23.44 | Professional | None | $14.79 | $22.91 | $23.44 |
Martin's Point Setting Facility Modifier None Typical Low $15.14 Median $144.54 Typical High $501.19 | Facility | None | $15.14 | $144.54 | $501.19 |
Martin's Point Setting Professional Modifier None Typical Low $13.18 Median $15.14 Typical High $28.84 | Professional | None | $13.18 | $15.14 | $28.84 |
Optum Setting Professional Modifier None Typical Low $21.88 Median $22.91 Typical High $25.12 | Professional | None | $21.88 | $22.91 | $25.12 |
Oscar Health Setting Professional Modifier None Typical Low $21.88 Median $22.91 Typical High $25.12 | Professional | None | $21.88 | $22.91 | $25.12 |
UPMC Health Plan Setting Facility Modifier None Typical Low $13.80 Median $46.77 Typical High $79.43 | Facility | None | $13.80 | $46.77 | $79.43 |
UPMC Health Plan Setting Professional Modifier None Typical Low $13.80 Median $23.44 Typical High $25.12 | Professional | None | $13.80 | $23.44 | $25.12 |
United Setting Facility Modifier None Typical Low $100.00 Median $208.93 Typical High $245.47 | Facility | None | $100.00 | $208.93 | $245.47 |
United Setting Professional Modifier None Typical Low $13.80 Median $21.88 Typical High $29.51 | Professional | None | $13.80 | $21.88 | $29.51 |
5 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 XU · Unusual separate service Typical Low $31.62 Median $128.82 Typical High $3,467.37 | Facility | XU · Unusual separate service | $31.62 | $128.82 | $3,467.37 |
Highmark BCBS Setting Facility Modifier 59 · Distinct service Typical Low $54.95 Median $134.90 Typical High $251.19 | Facility | 59 · Distinct service | $54.95 | $134.90 | $251.19 |
Highmark BCBS Setting Facility Modifier PN · Off-campus dept, non-excepted Typical Low $52.48 Median $97.72 Typical High $173.78 | Facility | PN · Off-campus dept, non-excepted | $52.48 | $97.72 | $173.78 |
Highmark BCBS Setting Facility Modifier XU · Unusual separate service Typical Low $57.54 Median $114.82 Typical High $245.47 | Facility | XU · Unusual separate service | $57.54 | $114.82 | $245.47 |
Martin's Point Setting Facility Modifier XU · Unusual separate service Typical Low $31.62 Median $128.82 Typical High $3,467.37 | Facility | XU · Unusual separate service | $31.62 | $128.82 | $3,467.37 |
Where Pennsylvania sits
The same service costs 7.4 times more in Vermont than in New York. 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· 20th of 51
$28.84
VT $112NY $15.14
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.