How much rates vary
Facilitymedian $1,148 · 10th to 90th $219 to $7,943Professionalmedian $257 · 10th to 90th $170 to $513
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 $181.97 Median $371.54 Typical High $4,073.80 | Facility | None | $181.97 | $371.54 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $309.03 | Professional | None | $165.96 | $218.78 | $309.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $102.33 Typical High $109.65 | Professional | 52 · Reduced service | $83.18 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $33.11 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.42 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.60 | $20.42 | $21.88 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $338.84 | Professional | None | $173.78 | $204.17 | $338.84 |
AmeriHealth Setting Facility Modifier None Typical Low $794.33 Median $1,698.24 Typical High $13,803.84 | Facility | None | $794.33 | $1,698.24 | $13,803.84 |
AmeriHealth Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $251.19 | Professional | None | $229.09 | $229.09 | $251.19 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,365.16 Median $5,754.40 Typical High $56,234.13 | Facility | None | $4,365.16 | $5,754.40 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $537.03 | Professional | None | $269.15 | $457.09 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,311.31 Typical High $4,786.30 | Facility | None | $1,348.96 | $3,311.31 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $380.19 | Professional | None | $199.53 | $251.19 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $660.69 | Professional | None | $363.08 | $467.74 | $660.69 |
Geisinger Setting Facility Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,090.30 | Facility | None | $1,995.26 | $2,511.89 | $3,090.30 |
Geisinger Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $562.34 | Professional | None | $223.87 | $323.59 | $562.34 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $11,481.54 | Facility | None | $1,778.28 | $2,398.83 | $11,481.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $363.08 | Professional | None | $234.42 | $263.03 | $363.08 |
Independence Blue Cross Setting Facility Modifier None Typical Low $794.33 Median $4,466.84 Typical High $22,387.21 | Facility | None | $794.33 | $4,466.84 | $22,387.21 |
Independence Blue Cross Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | None | $229.09 | $229.09 | $269.15 |
Martin's Point Setting Facility Modifier None Typical Low $181.97 Median $398.11 Typical High $4,570.88 | Facility | None | $181.97 | $398.11 | $4,570.88 |
Martin's Point Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $288.40 | Professional | None | $165.96 | $218.78 | $288.40 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $102.33 Typical High $109.65 | Professional | 52 · Reduced service | $83.18 | $102.33 | $109.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $33.11 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $33.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.42 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.60 | $20.42 | $21.88 |
Oscar Health Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $602.56 | Professional | None | $229.09 | $239.88 | $602.56 |
UPMC Health Plan Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $588.84 | Facility | None | $234.42 | $354.81 | $588.84 |
UPMC Health Plan Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $281.84 | Professional | None | $208.93 | $269.15 | $281.84 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $2,398.83 Typical High $2,818.38 | Facility | None | $1,148.15 | $2,398.83 | $2,818.38 |
United Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $371.54 | Professional | None | $190.55 | $239.88 | $371.54 |
8 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 25 · Same-day visit Typical Low $870.96 Median $2,137.96 Typical High $5,754.40 | Facility | 25 · Same-day visit | $870.96 | $2,137.96 | $5,754.40 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $194.98 Median $234.42 Typical High $251.19 | Professional | 25 · Same-day visit | $194.98 | $234.42 | $251.19 |
Ambetter Setting Professional Modifier G0 · Stroke telehealth Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | G0 · Stroke telehealth | $316.23 | $316.23 | $316.23 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $204.17 Median $204.17 Typical High $338.84 | Professional | GC · Resident with teaching physician | $204.17 | $204.17 | $338.84 |
Highmark BCBS Setting Facility Modifier 25 · Same-day visit Typical Low $1,023.29 Median $1,862.09 Typical High $5,011.87 | Facility | 25 · Same-day visit | $1,023.29 | $1,862.09 | $5,011.87 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $218.78 Median $245.47 Typical High $380.19 | Professional | 25 · Same-day visit | $218.78 | $245.47 | $380.19 |
Highmark BCBS Setting Professional Modifier GC · Resident with teaching physician Typical Low $234.42 Median $269.15 Typical High $389.05 | Professional | GC · Resident with teaching physician | $234.42 | $269.15 | $389.05 |
Martin's Point Setting Facility Modifier 25 · Same-day visit Typical Low $870.96 Median $2,137.96 Typical High $5,754.40 | Facility | 25 · Same-day visit | $870.96 | $2,137.96 | $5,754.40 |
Where Pennsylvania sits
The same service costs 2.8 times more in Minnesota 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· 32nd of 51
$257
MN $603NJ $214
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.