How much rates vary
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 $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Ambetter Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $9.12 | Professional | None | $3.24 | $3.24 | $9.12 |
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 $21.38 Median $21.38 Typical High $22.39 | Professional | None | $21.38 | $21.38 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Emblem Health Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Highmark BCBS Setting Facility Modifier None Typical Low $38.02 Median $47.86 Typical High $57.54 | Facility | None | $38.02 | $47.86 | $57.54 |
Independence Blue Cross Setting Professional Modifier None Typical Low $426.58 Median $707.95 Typical High $812.83 | Professional | None | $426.58 | $707.95 | $812.83 |
Martin's Point Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Martin's Point Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Optum Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $22.91 | Professional | None | $15.14 | $15.14 | $22.91 |
Oscar Health Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
UPMC Health Plan Setting Facility Modifier None Typical Low $44.67 Median $60.26 Typical High $100.00 | Facility | None | $44.67 | $60.26 | $100.00 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $22.91 | Professional | None | $15.14 | $15.14 | $22.91 |
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 |
|---|---|---|---|---|---|
UPMC Health Plan Setting Professional Modifier HE · Mental health program + HK · High-risk mental health + HT · Multidisciplinary team + UK · On patient's behalf Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | HE · Mental health program + HK · High-risk mental health + HT · Multidisciplinary team + UK · On patient's behalf | $28.84 | $28.84 | $28.84 |
Where Pennsylvania sits
The same service costs 8.7 times more in Montana than in California. 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· 20th of 51
$21.38
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.