How much rates vary
Facilitymedian $28 · 10th to 90th $23 to $32Professionalmedian $30 · 10th to 90th $23 to $42
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 $23.44 Median $26.92 Typical High $30.90 | Facility | None | $23.44 | $26.92 | $30.90 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $13.18 Median $13.80 Typical High $15.14 | Facility | 52 · Reduced service | $13.18 | $13.80 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $26.92 Typical High $30.90 | Professional | None | $21.88 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $13.80 Typical High $14.45 | Professional | 52 · Reduced service | $13.18 | $13.80 | $14.45 |
Ambetter Setting Professional Modifier None Typical Low $22.91 Median $28.18 Typical High $50.12 | Professional | None | $22.91 | $28.18 | $50.12 |
AmeriHealth Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $691.83 | Professional | None | $331.13 | $436.52 | $691.83 |
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 $30.90 Median $31.62 Typical High $50.12 | Professional | None | $30.90 | $31.62 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $35.48 Typical High $50.12 | Professional | None | $28.18 | $35.48 | $50.12 |
Emblem Health Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
Emblem Health Setting Professional Modifier None Typical Low $12.59 Median $13.80 Typical High $52.48 | Professional | None | $12.59 | $13.80 | $52.48 |
Geisinger Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $57.54 | Professional | None | $30.20 | $33.11 | $57.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $22.39 Median $30.20 Typical High $2,041.74 | Facility | None | $22.39 | $30.20 | $2,041.74 |
Highmark BCBS Setting Professional Modifier None Typical Low $26.30 Median $33.11 Typical High $75.86 | Professional | None | $26.30 | $33.11 | $75.86 |
Independence Blue Cross Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $630.96 | Professional | None | $245.47 | $416.87 | $630.96 |
Martin's Point Setting Facility Modifier None Typical Low $23.44 Median $26.92 Typical High $30.20 | Facility | None | $23.44 | $26.92 | $30.20 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $13.18 Median $13.80 Typical High $15.14 | Facility | 52 · Reduced service | $13.18 | $13.80 | $15.14 |
Martin's Point Setting Professional Modifier None Typical Low $21.88 Median $26.92 Typical High $30.90 | Professional | None | $21.88 | $26.92 | $30.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $13.80 Typical High $14.45 | Professional | 52 · Reduced service | $13.18 | $13.80 | $14.45 |
Optum Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $34.67 | Professional | None | $30.90 | $30.90 | $34.67 |
Oscar Health Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $38.02 | Professional | None | $30.90 | $30.90 | $38.02 |
United Setting Professional Modifier None Typical Low $28.18 Median $31.62 Typical High $43.65 | Professional | None | $28.18 | $31.62 | $43.65 |
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 Professional Modifier AF · Specialist physician Typical Low $29.51 Median $48.98 Typical High $58.88 | Professional | AF · Specialist physician | $29.51 | $48.98 | $58.88 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $21.88 Median $36.31 Typical High $43.65 | Professional | HO · Master's level | $21.88 | $36.31 | $43.65 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $25.12 Median $41.69 Typical High $50.12 | Professional | TD · Registered nurse | $25.12 | $41.69 | $50.12 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | GC · Resident with teaching physician | $28.18 | $28.18 | $28.18 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $28.18 Median $30.90 Typical High $54.95 | Professional | 25 · Same-day visit | $28.18 | $30.90 | $54.95 |
Martin's Point Setting Professional Modifier AF · Specialist physician Typical Low $29.51 Median $48.98 Typical High $58.88 | Professional | AF · Specialist physician | $29.51 | $48.98 | $58.88 |
Martin's Point Setting Professional Modifier HO · Master's level Typical Low $21.88 Median $36.31 Typical High $43.65 | Professional | HO · Master's level | $21.88 | $36.31 | $43.65 |
Martin's Point Setting Professional Modifier TD · Registered nurse Typical Low $25.12 Median $41.69 Typical High $50.12 | Professional | TD · Registered nurse | $25.12 | $41.69 | $50.12 |
Where Pennsylvania sits
The same service costs 2.5 times more in Alaska than in New York. 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· 37th of 51
$29.51
AK $60.26NY $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.