How much rates vary
Facilitymedian $25 · 10th to 90th $21 to $76Professionalmedian $22 · 10th to 90th $21 to $32
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 $20.89 Median $72.44 Typical High $131.83 | Facility | None | $20.89 | $72.44 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | None | $20.89 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.47 Typical High $10.72 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.27 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.14 |
Capital Blue Cross Setting Facility Modifier None Typical Low $19.95 Median $22.91 Typical High $26.92 | Facility | None | $19.95 | $22.91 | $26.92 |
Capital Blue Cross Setting Professional Modifier None Typical Low $19.50 Median $21.88 Typical High $21.88 | Professional | None | $19.50 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $34.67 Typical High $79.43 | Facility | None | $20.89 | $34.67 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Emblem Health Setting Professional Modifier None Typical Low $16.60 Median $21.88 Typical High $29.51 | Professional | None | $16.60 | $21.88 | $29.51 |
Geisinger Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Geisinger Setting Professional Modifier None Typical Low $20.89 Median $27.54 Typical High $41.69 | Professional | None | $20.89 | $27.54 | $41.69 |
Martin's Point Setting Facility Modifier None Typical Low $20.89 Median $72.44 Typical High $131.83 | Facility | None | $20.89 | $72.44 | $131.83 |
Martin's Point Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | None | $20.89 | $20.89 | $21.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.47 Typical High $10.72 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.72 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.27 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.27 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.14 |
Oscar Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $138.04 | Professional | None | $30.20 | $30.20 | $138.04 |
UPMC Health Plan Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $67.61 | Facility | None | $24.55 | $24.55 | $67.61 |
UPMC Health Plan Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | None | $58.88 | $58.88 | $67.61 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $38.02 | Professional | None | $27.54 | $31.62 | $38.02 |
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 Facility Modifier TB · 340B drug Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | TB · 340B drug | $114.82 | $114.82 | $114.82 |
Where Pennsylvania sits
The same service costs 3.8 times more in Wyoming 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· 32nd of 51
$21.88
WY $79.43KY $20.89
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.