How much rates vary
Facilitymedian $100 · 10th to 90th $65 to $1,862Professionalmedian $110 · 10th to 90th $74 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 $74.13 Median $100.00 Typical High $204.17 | Facility | None | $74.13 | $100.00 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $112.20 | Professional | None | $74.13 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $37.15 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $10.96 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.41 | $8.91 | $10.47 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $169.82 | Professional | None | $102.33 | $125.89 | $169.82 |
AmeriHealth Setting Facility Modifier None Typical Low $426.58 Median $1,096.48 Typical High $1,949.84 | Facility | None | $426.58 | $1,096.48 | $1,949.84 |
AmeriHealth Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $134.90 | Professional | None | $100.00 | $131.83 | $134.90 |
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 $125.89 Median $194.98 Typical High $229.09 | Professional | None | $125.89 | $194.98 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $138.04 | Professional | None | $63.10 | $89.13 | $138.04 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $54.95 Typical High $204.17 | Professional | None | $30.90 | $54.95 | $204.17 |
Geisinger Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $169.82 | Professional | None | $72.44 | $85.11 | $169.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $251.19 | Facility | None | $72.44 | $102.33 | $251.19 |
Highmark BCBS Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $190.55 | Professional | None | $102.33 | $128.82 | $190.55 |
Independence Blue Cross Setting Facility Modifier None Typical Low $436.52 Median $1,023.29 Typical High $2,041.74 | Facility | None | $436.52 | $1,023.29 | $2,041.74 |
Independence Blue Cross Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $131.83 | Professional | None | $100.00 | $131.83 | $131.83 |
Martin's Point Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $204.17 | Facility | None | $74.13 | $100.00 | $204.17 |
Martin's Point Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $104.71 | Professional | None | $74.13 | $95.50 | $104.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $37.15 | $44.67 | $52.48 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $10.96 | $13.18 | $15.85 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.41 | $8.91 | $10.47 |
Oscar Health Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $223.87 | Professional | None | $83.18 | $131.83 | $223.87 |
UPMC Health Plan Setting Facility Modifier None Typical Low $53.70 Median $83.18 Typical High $112.20 | Facility | None | $53.70 | $83.18 | $112.20 |
UPMC Health Plan Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | None | $95.50 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $141.25 | Professional | None | $75.86 | $100.00 | $141.25 |
7 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 $100.00 Median $117.49 Typical High $165.96 | Professional | 25 · Same-day visit | $100.00 | $117.49 | $165.96 |
Ambetter Setting Professional Modifier EP · Child screening program Typical Low $91.20 Median $102.33 Typical High $177.83 | Professional | EP · Child screening program | $91.20 | $102.33 | $177.83 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | FP · Family planning | $100.00 | $100.00 | $100.00 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $77.62 Median $100.00 Typical High $169.82 | Professional | GC · Resident with teaching physician | $77.62 | $100.00 | $169.82 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $100.00 Median $181.97 Typical High $181.97 | Professional | GE · Resident, primary care exception | $100.00 | $181.97 | $181.97 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $107.15 Median $120.23 Typical High $158.49 | Professional | 25 · Same-day visit | $107.15 | $120.23 | $158.49 |
Highmark BCBS Setting Professional Modifier GC · Resident with teaching physician Typical Low $102.33 Median $128.82 Typical High $173.78 | Professional | GC · Resident with teaching physician | $102.33 | $128.82 | $173.78 |
Where Pennsylvania sits
The same service costs 2.7 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· 28th of 51
$110
AK $224DC $83.18
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.