How much rates vary
Facilitymedian $46 · 10th to 90th $29 to $178Professionalmedian $43 · 10th to 90th $28 to $62
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 $28.84 Median $44.67 Typical High $85.11 | Facility | None | $28.84 | $44.67 | $85.11 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $14.13 Median $16.98 Typical High $23.44 | Facility | 52 · Reduced service | $14.13 | $16.98 | $23.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $5.13 Typical High $6.92 | Facility | 55 · Aftercare only | $4.27 | $5.13 | $6.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.39 Typical High $4.68 | Facility | 56 · Pre-op care only | $2.82 | $3.39 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $39.81 Typical High $50.12 | Professional | None | $28.18 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $16.60 Typical High $22.39 | Professional | 52 · Reduced service | $14.13 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.90 Typical High $6.61 | Professional | 55 · Aftercare only | $4.27 | $4.90 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.31 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.82 | $3.31 | $4.47 |
Ambetter Setting Professional Modifier None Typical Low $27.54 Median $56.23 Typical High $91.20 | Professional | None | $27.54 | $56.23 | $91.20 |
AmeriHealth Setting Facility Modifier None Typical Low $36.31 Median $104.71 Typical High $346.74 | Facility | None | $36.31 | $104.71 | $346.74 |
AmeriHealth Setting Professional Modifier None Typical Low $37.15 Median $50.12 Typical High $58.88 | Professional | None | $37.15 | $50.12 | $58.88 |
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 $61.66 Median $61.66 Typical High $89.13 | Professional | None | $61.66 | $61.66 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $147.91 Typical High $257.04 | Facility | None | $109.65 | $147.91 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $38.02 Typical High $57.54 | Professional | None | $21.88 | $38.02 | $57.54 |
Emblem Health Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $100.00 | Professional | None | $30.90 | $38.90 | $100.00 |
Geisinger Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $41.69 | Facility | None | $34.67 | $34.67 | $41.69 |
Geisinger Setting Professional Modifier None Typical Low $34.67 Median $58.88 Typical High $100.00 | Professional | None | $34.67 | $58.88 | $100.00 |
Highmark BCBS Setting Facility Modifier None Typical Low $38.02 Median $95.50 Typical High $199.53 | Facility | None | $38.02 | $95.50 | $199.53 |
Highmark BCBS Setting Professional Modifier None Typical Low $35.48 Median $60.26 Typical High $95.50 | Professional | None | $35.48 | $60.26 | $95.50 |
Independence Blue Cross Setting Facility Modifier None Typical Low $36.31 Median $107.15 Typical High $346.74 | Facility | None | $36.31 | $107.15 | $346.74 |
Independence Blue Cross Setting Professional Modifier None Typical Low $33.88 Median $50.12 Typical High $58.88 | Professional | None | $33.88 | $50.12 | $58.88 |
Martin's Point Setting Facility Modifier None Typical Low $28.18 Median $44.67 Typical High $85.11 | Facility | None | $28.18 | $44.67 | $85.11 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $14.13 Median $16.98 Typical High $23.44 | Facility | 52 · Reduced service | $14.13 | $16.98 | $23.44 |
Martin's Point Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $5.13 Typical High $6.92 | Facility | 55 · Aftercare only | $4.27 | $5.13 | $6.92 |
Martin's Point Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.39 Typical High $4.68 | Facility | 56 · Pre-op care only | $2.82 | $3.39 | $4.68 |
Martin's Point Setting Professional Modifier None Typical Low $28.18 Median $40.74 Typical High $50.12 | Professional | None | $28.18 | $40.74 | $50.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $16.60 Typical High $22.39 | Professional | 52 · Reduced service | $14.13 | $16.60 | $22.39 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.90 Typical High $6.61 | Professional | 55 · Aftercare only | $4.27 | $4.90 | $6.61 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.39 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.82 | $3.39 | $4.47 |
Optum Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $60.26 | Professional | None | $48.98 | $57.54 | $60.26 |
Oscar Health Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $79.43 | Professional | None | $39.81 | $57.54 | $79.43 |
UPMC Health Plan Setting Facility Modifier None Typical Low $34.67 Median $54.95 Typical High $134.90 | Facility | None | $34.67 | $54.95 | $134.90 |
UPMC Health Plan Setting Professional Modifier None Typical Low $34.67 Median $45.71 Typical High $56.23 | Professional | None | $34.67 | $45.71 | $56.23 |
United Setting Professional Modifier None Typical Low $21.88 Median $36.31 Typical High $57.54 | Professional | None | $21.88 | $36.31 | $57.54 |
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 Professional Modifier AF · Specialist physician Typical Low $34.67 Median $47.86 Typical High $107.15 | Professional | AF · Specialist physician | $34.67 | $47.86 | $107.15 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $34.67 Median $42.66 Typical High $79.43 | Professional | HO · Master's level | $34.67 | $42.66 | $79.43 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $38.90 Median $48.98 Typical High $89.13 | Professional | TD · Registered nurse | $38.90 | $48.98 | $89.13 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $47.86 Median $56.23 Typical High $91.20 | Professional | 25 · Same-day visit | $47.86 | $56.23 | $91.20 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $50.12 Median $61.66 Typical High $91.20 | Professional | 93 · Audio-only telehealth | $50.12 | $61.66 | $91.20 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | FP · Family planning | $47.86 | $47.86 | $47.86 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $56.23 Median $74.13 Typical High $109.65 | Professional | GC · Resident with teaching physician | $56.23 | $74.13 | $109.65 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $56.23 Median $87.10 Typical High $87.10 | Professional | GE · Resident, primary care exception | $56.23 | $87.10 | $87.10 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | U7 · State-defined | $56.23 | $56.23 | $56.23 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $34.67 Median $57.54 Typical High $89.13 | Professional | 25 · Same-day visit | $34.67 | $57.54 | $89.13 |
Martin's Point Setting Professional Modifier AF · Specialist physician Typical Low $34.67 Median $48.98 Typical High $107.15 | Professional | AF · Specialist physician | $34.67 | $48.98 | $107.15 |
Martin's Point Setting Professional Modifier HO · Master's level Typical Low $34.67 Median $42.66 Typical High $79.43 | Professional | HO · Master's level | $34.67 | $42.66 | $79.43 |
Martin's Point Setting Professional Modifier TD · Registered nurse Typical Low $38.90 Median $48.98 Typical High $89.13 | Professional | TD · Registered nurse | $38.90 | $48.98 | $89.13 |
Where Pennsylvania sits
The same service costs 2.4 times more in Alaska than in New Jersey. 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· 28th of 51
$42.66
AK $77.62NJ $32.36
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.