How much rates vary
Facilitymedian $41 · 10th to 90th $22 to $4,266Professionalmedian $35 · 10th to 90th $21 to $69
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 $20.42 Median $33.88 Typical High $1,412.54 | Facility | None | $20.42 | $33.88 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $31.62 Typical High $34.67 | Professional | None | $20.42 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $13.80 Typical High $17.38 | Professional | 52 · Reduced service | $10.23 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $4.17 Typical High $5.25 | Professional | 55 · Aftercare only | $3.09 | $4.17 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.82 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.04 | $2.82 | $3.47 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $40.74 | Professional | None | $33.11 | $34.67 | $40.74 |
AmeriHealth Setting Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $40.74 | Professional | None | $34.67 | $40.74 | $40.74 |
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 $38.02 Median $61.66 Typical High $79.43 | Professional | None | $38.02 | $61.66 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $35.48 Typical High $45.71 | Professional | None | $21.88 | $35.48 | $45.71 |
Emblem Health Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $85.11 | Professional | None | $46.77 | $60.26 | $85.11 |
Geisinger Setting Professional Modifier None Typical Low $30.20 Median $35.48 Typical High $64.57 | Professional | None | $30.20 | $35.48 | $64.57 |
Highmark BCBS Setting Facility Modifier None Typical Low $20.89 Median $75.86 Typical High $91.20 | Facility | None | $20.89 | $75.86 | $91.20 |
Highmark BCBS Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $64.57 | Professional | None | $38.02 | $41.69 | $64.57 |
Independence Blue Cross Setting Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $40.74 | Professional | None | $34.67 | $40.74 | $40.74 |
Johns Hopkins Employer Health Plan Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Martin's Point Setting Facility Modifier None Typical Low $20.42 Median $33.88 Typical High $1,862.09 | Facility | None | $20.42 | $33.88 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $20.42 Median $31.62 Typical High $34.67 | Professional | None | $20.42 | $31.62 | $34.67 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $14.13 Typical High $17.38 | Professional | 52 · Reduced service | $10.23 | $14.13 | $17.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $4.27 Typical High $5.25 | Professional | 55 · Aftercare only | $3.09 | $4.27 | $5.25 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.82 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.04 | $2.82 | $3.47 |
Oscar Health Setting Professional Modifier None Typical Low $25.70 Median $37.15 Typical High $72.44 | Professional | None | $25.70 | $37.15 | $72.44 |
UPMC Health Plan Setting Facility Modifier None Typical Low $33.11 Median $40.74 Typical High $58.88 | Facility | None | $33.11 | $40.74 | $58.88 |
UPMC Health Plan Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $40.74 | Professional | None | $33.11 | $34.67 | $40.74 |
United Setting Professional Modifier None Typical Low $22.39 Median $33.88 Typical High $44.67 | Professional | None | $22.39 | $33.88 | $44.67 |
2 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 $20.42 Median $38.02 Typical High $38.90 | Professional | 25 · Same-day visit | $20.42 | $38.02 | $38.90 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $38.02 Median $41.69 Typical High $43.65 | Professional | 25 · Same-day visit | $38.02 | $41.69 | $43.65 |
Where Pennsylvania sits
The same service costs 2.8 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· 26th of 51
$35.48
AK $66.07DC $23.99
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.