Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.
| Insurance Carrier | Facility/Professional | Modifier | Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High. | MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High. | Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High. |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier Global Typical Low $12.88 Median $16.98 Typical High $46.77 | Professional | Global | $12.88 | $16.98 | $46.77 |
Ambetter Setting Professional Modifier Global Typical Low $17.78 Median $25.70 Typical High $25.70 | Professional | Global | $17.78 | $25.70 | $25.70 |
AmeriHealth Setting Professional Modifier Global Typical Low $19.05 Median $19.50 Typical High $20.42 | Professional | Global | $19.05 | $19.50 | $20.42 |
Capital Blue Cross Setting Professional Modifier Global Typical Low $21.88 Median $25.70 Typical High $46.77 | Professional | Global | $21.88 | $25.70 | $46.77 |
Cigna Setting Facility Modifier Global Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | Global | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier Global Typical Low $18.62 Median $33.88 Typical High $45.71 | Professional | Global | $18.62 | $33.88 | $45.71 |
Geisinger Setting Professional Modifier Global Typical Low $15.14 Median $17.78 Typical High $30.20 | Professional | Global | $15.14 | $17.78 | $30.20 |
Highmark BCBS Setting Professional Modifier Global Typical Low $20.89 Median $22.39 Typical High $22.91 | Professional | Global | $20.89 | $22.39 | $22.91 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 25 · Same-day visit | $21.38 | $21.38 | $21.38 |
Highmark BCBS Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $11.22 | $11.48 | $11.48 |
Independence Blue Cross Setting Professional Modifier Global Typical Low $19.50 Median $19.50 Typical High $20.42 | Professional | Global | $19.50 | $19.50 | $20.42 |
Martin's Point Setting Professional Modifier Global Typical Low $14.79 Median $16.60 Typical High $20.89 | Professional | Global | $14.79 | $16.60 | $20.89 |
Optum Setting Professional Modifier Global Typical Low $25.70 Median $30.90 Typical High $39.81 | Professional | Global | $25.70 | $30.90 | $39.81 |
UPMC Health Plan Setting Professional Modifier Global Typical Low $19.05 Median $25.70 Typical High $67.61 | Professional | Global | $19.05 | $25.70 | $67.61 |
United Setting Professional Modifier Global Typical Low $20.42 Median $25.12 Typical High $33.11 | Professional | Global | $20.42 | $25.12 | $33.11 |