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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $21.88 | Professional | None | $19.50 | $19.50 | $21.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $25.70 | Professional | None | $19.50 | $19.50 | $25.70 |
CDPHP Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $93.33 | Facility | None | $22.39 | $22.39 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $102.33 | Professional | None | $21.38 | $21.38 | $102.33 |
Emblem Health Setting Facility Modifier None Typical Low $20.42 Median $26.30 Typical High $45.71 | Facility | None | $20.42 | $26.30 | $45.71 |
Emblem Health Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $39.81 | Professional | None | $20.42 | $20.42 | $39.81 |
MVP Health Care Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
MVP Health Care Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
United Setting Facility Modifier None Typical Low $14.13 Median $14.79 Typical High $16.60 | Facility | None | $14.13 | $14.79 | $16.60 |
United Setting Professional Modifier None Typical Low $22.91 Median $26.92 Typical High $34.67 | Professional | None | $22.91 | $26.92 | $34.67 |
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 52 · Reduced service Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $1.95 |
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 |
Excellus BCBS Setting Professional Modifier SL · State-supplied vaccine Typical Low $17.78 Median $25.12 Typical High $26.30 | Professional | SL · State-supplied vaccine | $17.78 | $25.12 | $26.30 |
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 |
Univera Setting Professional Modifier SL · State-supplied vaccine Typical Low $17.78 Median $25.12 Typical High $30.20 | Professional | SL · State-supplied vaccine | $17.78 | $25.12 | $30.20 |
Where New York sits
The same service costs 2.0 times more in Alabama than in Connecticut. 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· 48th of 51
$20.42
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.