How much rates vary
Facilitymedian $98 · 10th to 90th $63 to $1,862Professionalmedian $102 · 10th to 90th $63 to $204
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 $63.10 Median $93.33 Typical High $1,412.54 | Facility | None | $63.10 | $93.33 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $102.33 | Professional | None | $63.10 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $39.81 Typical High $48.98 | Professional | 52 · Reduced service | $31.62 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.02 Typical High $14.79 | Professional | 55 · Aftercare only | $9.55 | $12.02 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.94 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.31 | $7.94 | $9.77 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $218.78 | Professional | None | $109.65 | $109.65 | $218.78 |
AmeriHealth Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $204.17 | Professional | None | $104.71 | $123.03 | $204.17 |
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 $117.49 Median $177.83 Typical High $208.93 | Professional | None | $117.49 | $177.83 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $128.82 | Professional | None | $54.95 | $91.20 | $128.82 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $60.26 Typical High $190.55 | Professional | None | $30.90 | $60.26 | $190.55 |
Geisinger Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $173.78 | Professional | None | $75.86 | $89.13 | $173.78 |
Highmark BCBS Setting Facility Modifier None Typical Low $93.33 Median $100.00 Typical High $114.82 | Facility | None | $93.33 | $100.00 | $114.82 |
Highmark BCBS Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $158.49 | Professional | None | $109.65 | $131.83 | $158.49 |
Independence Blue Cross Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $204.17 | Professional | None | $104.71 | $134.90 | $204.17 |
Martin's Point Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $93.33 | Facility | None | $63.10 | $93.33 | $93.33 |
Martin's Point Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $97.72 | Professional | None | $63.10 | $89.13 | $97.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $39.81 Typical High $48.98 | Professional | 52 · Reduced service | $31.62 | $39.81 | $48.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $12.02 Typical High $14.79 | Professional | 55 · Aftercare only | $9.55 | $12.02 | $14.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.94 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.31 | $7.94 | $9.77 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $213.80 | Professional | None | $104.71 | $114.82 | $213.80 |
UPMC Health Plan Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $123.03 | Facility | None | $72.44 | $102.33 | $123.03 |
UPMC Health Plan Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $123.03 | Professional | None | $102.33 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $125.89 | Professional | None | $66.07 | $89.13 | $125.89 |
3 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $93.33 Median $123.03 Typical High $177.83 | Professional | 25 · Same-day visit | $93.33 | $123.03 | $177.83 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $83.18 Median $100.00 Typical High $100.00 | Professional | EP · Child screening program | $83.18 | $100.00 | $100.00 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $109.65 Median $128.82 Typical High $165.96 | Professional | 25 · Same-day visit | $109.65 | $128.82 | $165.96 |
Where Pennsylvania sits
The same service costs 2.9 times more in Alaska than in Washington, DC. 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· 27th of 51
$102
AK $204DC $70.79
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.