How much rates vary
Facilitymedian $151 · 10th to 90th $32 to $2,630Professionalmedian $18 · 10th to 90th $15 to $35
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 $17.38 Median $204.17 Typical High $741.31 | Facility | None | $17.38 | $204.17 | $741.31 |
Aetna Setting Facility Modifier 59 · Distinct service Typical Low $91.20 Median $257.04 Typical High $851.14 | Facility | 59 · Distinct service | $91.20 | $257.04 | $851.14 |
Aetna Setting Facility Modifier XU · Unusual separate service Typical Low $48.98 Median $204.17 Typical High $489.78 | Facility | XU · Unusual separate service | $48.98 | $204.17 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $17.38 Typical High $25.70 | Professional | None | $14.79 | $17.38 | $25.70 |
Ambetter Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
AmeriHealth Setting Facility Modifier None Typical Low $436.52 Median $2,630.27 Typical High $4,897.79 | Facility | None | $436.52 | $2,630.27 | $4,897.79 |
AmeriHealth Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $28.84 | Professional | None | $27.54 | $27.54 | $28.84 |
Capital Blue Cross Setting Facility Modifier None Typical Low $134.90 Median $5,011.87 Typical High $56,234.13 | Facility | None | $134.90 | $5,011.87 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $13.18 Median $15.49 Typical High $32.36 | Professional | None | $13.18 | $15.49 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $107.15 Typical High $128.82 | Facility | None | $47.86 | $107.15 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $26.30 Typical High $37.15 | Professional | None | $14.13 | $26.30 | $37.15 |
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 $75.86 Median $125.89 Typical High $199.53 | Facility | None | $75.86 | $125.89 | $199.53 |
Highmark BCBS Setting Facility Modifier 59 · Distinct service Typical Low $48.98 Median $107.15 Typical High $162.18 | Facility | 59 · Distinct service | $48.98 | $107.15 | $162.18 |
Highmark BCBS Setting Facility Modifier XU · Unusual separate service Typical Low $66.07 Median $117.49 Typical High $208.93 | Facility | XU · Unusual separate service | $66.07 | $117.49 | $208.93 |
Independence Blue Cross Setting Facility Modifier None Typical Low $67.61 Median $2,884.03 Typical High $7,079.46 | Facility | None | $67.61 | $2,884.03 | $7,079.46 |
Independence Blue Cross Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Martin's Point Setting Facility Modifier None Typical Low $17.78 Median $208.93 Typical High $758.58 | Facility | None | $17.78 | $208.93 | $758.58 |
Martin's Point Setting Facility Modifier 59 · Distinct service Typical Low $91.20 Median $251.19 Typical High $851.14 | Facility | 59 · Distinct service | $91.20 | $251.19 | $851.14 |
Martin's Point Setting Facility Modifier XU · Unusual separate service Typical Low $47.86 Median $204.17 Typical High $489.78 | Facility | XU · Unusual separate service | $47.86 | $204.17 | $489.78 |
Martin's Point Setting Professional Modifier None Typical Low $14.79 Median $17.38 Typical High $25.70 | Professional | None | $14.79 | $17.38 | $25.70 |
Oscar Health Setting Facility Modifier None Typical Low $812.83 Median $1,096.48 Typical High $2,290.87 | Facility | None | $812.83 | $1,096.48 | $2,290.87 |
UPMC Health Plan Setting Facility Modifier None Typical Low $14.79 Median $83.18 Typical High $141.25 | Facility | None | $14.79 | $83.18 | $141.25 |
UPMC Health Plan Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $46.77 | Professional | None | $14.79 | $14.79 | $46.77 |
United Setting Facility Modifier None Typical Low $64.57 Median $138.04 Typical High $158.49 | Facility | None | $64.57 | $138.04 | $158.49 |
United Setting Professional Modifier None Typical Low $15.14 Median $23.99 Typical High $34.67 | Professional | None | $15.14 | $23.99 | $34.67 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier PN · Off-campus dept, non-excepted Typical Low $34.67 Median $69.18 Typical High $169.82 | Facility | PN · Off-campus dept, non-excepted | $34.67 | $69.18 | $169.82 |
Where Pennsylvania sits
The same service costs 8.5 times more in Vermont than in Maryland. 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· 4th of 51
$100
VT $141MD $16.60
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.