How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $21.88 Median $25.70 Typical High $29.51 | Facility | None | $21.88 | $25.70 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $29.51 | Professional | None | $20.89 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $11.75 Typical High $14.45 | Professional | 52 · Reduced service | $10.47 | $11.75 | $14.45 |
Ambetter Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $38.90 | Professional | None | $28.18 | $30.20 | $38.90 |
AmeriHealth Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $26.92 | Professional | None | $23.99 | $26.92 | $26.92 |
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 $32.36 Median $33.88 Typical High $36.31 | Professional | None | $32.36 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Emblem Health Setting Professional Modifier None Typical Low $33.11 Median $48.98 Typical High $60.26 | Professional | None | $33.11 | $48.98 | $60.26 |
Geisinger Setting Professional Modifier None Typical Low $24.55 Median $33.11 Typical High $58.88 | Professional | None | $24.55 | $33.11 | $58.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $223.87 | Facility | None | $213.80 | $213.80 | $223.87 |
Independence Blue Cross Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Martin's Point Setting Facility Modifier None Typical Low $21.88 Median $25.70 Typical High $29.51 | Facility | None | $21.88 | $25.70 | $29.51 |
Martin's Point Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $29.51 | Professional | None | $20.89 | $23.44 | $29.51 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $11.75 Typical High $14.45 | Professional | 52 · Reduced service | $10.47 | $11.75 | $14.45 |
UPMC Health Plan Setting Facility Modifier None Typical Low $20.89 Median $22.39 Typical High $25.12 | Facility | None | $20.89 | $22.39 | $25.12 |
UPMC Health Plan Setting Professional Modifier None Typical Low $20.89 Median $22.91 Typical High $25.12 | Professional | None | $20.89 | $22.91 | $25.12 |
United Setting Facility Modifier None Typical Low $141.25 Median $295.12 Typical High $346.74 | Facility | None | $141.25 | $295.12 | $346.74 |
United Setting Professional Modifier None Typical Low $20.89 Median $25.12 Typical High $47.86 | Professional | None | $20.89 | $25.12 | $47.86 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier 25 · Same-day visit + 59 · Distinct service Typical Low $32.36 Median $32.36 Typical High $35.48 | Professional | 25 · Same-day visit + 59 · Distinct service | $32.36 | $32.36 | $35.48 |
Where Pennsylvania sits
The same service costs 2.7 times more in North Dakota than in Kentucky. 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· 25th of 51
$26.92
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.