How much rates vary
Facilitymedian $91 · 10th to 90th $60 to $4,266Professionalmedian $83 · 10th to 90th $59 to $158
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 $58.88 Median $85.11 Typical High $1,412.54 | Facility | None | $58.88 | $85.11 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $91.20 | Professional | None | $58.88 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $36.31 Typical High $44.67 | Professional | 52 · Reduced service | $28.84 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.72 Typical High $13.49 | Professional | 55 · Aftercare only | $8.71 | $10.72 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.24 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.89 | $7.24 | $8.91 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $194.98 | Professional | None | $79.43 | $114.82 | $194.98 |
AmeriHealth Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $147.91 | Professional | None | $85.11 | $109.65 | $147.91 |
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 $158.49 Median $158.49 Typical High $239.88 | Professional | None | $158.49 | $158.49 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $114.82 | Professional | None | $46.77 | $72.44 | $114.82 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $120.23 Typical High $169.82 | Professional | None | $30.90 | $120.23 | $169.82 |
Geisinger Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $138.04 | Professional | None | $58.88 | $69.18 | $138.04 |
Highmark BCBS Setting Facility Modifier None Typical Low $69.18 Median $70.79 Typical High $97.72 | Facility | None | $69.18 | $70.79 | $97.72 |
Highmark BCBS Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $147.91 | Professional | None | $95.50 | $120.23 | $147.91 |
Independence Blue Cross Setting Professional Modifier None Typical Low $95.50 Median $120.23 Typical High $165.96 | Professional | None | $95.50 | $120.23 | $165.96 |
Martin's Point Setting Facility Modifier None Typical Low $58.88 Median $85.11 Typical High $1,862.09 | Facility | None | $58.88 | $85.11 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $89.13 | Professional | None | $58.88 | $81.28 | $89.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $36.31 Typical High $44.67 | Professional | 52 · Reduced service | $28.84 | $36.31 | $44.67 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.72 Typical High $13.49 | Professional | 55 · Aftercare only | $8.71 | $10.72 | $13.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.24 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.89 | $7.24 | $8.91 |
Oscar Health Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $190.55 | Professional | None | $67.61 | $100.00 | $190.55 |
UPMC Health Plan Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $120.23 | Facility | None | $74.13 | $95.50 | $120.23 |
UPMC Health Plan Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | None | $81.28 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $114.82 | Professional | None | $56.23 | $79.43 | $114.82 |
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 $89.13 Median $100.00 Typical High $181.97 | Professional | 25 · Same-day visit | $89.13 | $100.00 | $181.97 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $114.82 Typical High $144.54 | Professional | 25 · Same-day visit | $100.00 | $114.82 | $144.54 |
UPMC Health Plan Setting Professional Modifier EP · Child screening program Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | EP · Child screening program | $87.10 | $95.50 | $95.50 |
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· 34th of 51
$83.18
AK $186DC $64.57
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.