How much rates vary
Facilitymedian $87 · 10th to 90th $85 to $100Professionalmedian $85 · 10th to 90th $85 to $132
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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $102.33 | Professional | None | $87.10 | $87.10 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
CDPHP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $144.54 | Facility | None | $89.13 | $89.13 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $457.09 | Professional | None | $95.50 | $95.50 | $457.09 |
Emblem Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $141.25 | Facility | None | $87.10 | $87.10 | $141.25 |
Emblem Health Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | None | $74.13 | $87.10 | $87.10 |
Excellus BCBS Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $87.10 | Facility | None | $85.11 | $85.11 | $87.10 |
Excellus BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $87.10 | Professional | None | $85.11 | $85.11 | $87.10 |
Highmark BCBS Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
MVP Health Care Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
MVP Health Care Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
United Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $131.83 | Professional | None | $85.11 | $100.00 | $131.83 |
Univera Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $93.33 | Facility | None | $85.11 | $85.11 | $93.33 |
Univera Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | None | $85.11 | $85.11 | $102.33 |
6 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 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Excellus BCBS Setting Facility Modifier SL · State-supplied vaccine Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | SL · State-supplied vaccine | $25.12 | $25.12 | $25.12 |
Univera Setting Facility Modifier SL · State-supplied vaccine Typical Low $25.12 Median $25.12 Typical High $26.30 | Facility | SL · State-supplied vaccine | $25.12 | $25.12 | $26.30 |
Where New York sits
The same service costs 1.7 times more in Texas than in Arkansas. 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.
New York· 49th of 51
$85.11
TX $148AR $85.11
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.