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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
CDPHP Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $263.03 | Facility | None | $70.79 | $74.13 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | None | $74.13 | $74.13 | $89.13 |
Emblem Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $109.65 | Facility | None | $67.61 | $67.61 | $109.65 |
Emblem Health Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $67.61 | Professional | None | $46.77 | $67.61 | $67.61 |
MVP Health Care Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
MVP Health Care Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $89.13 | Professional | None | $66.07 | $77.62 | $89.13 |
Univera Setting Facility Modifier None Typical Low $24.55 Median $35.48 Typical High $35.48 | Facility | None | $24.55 | $35.48 | $35.48 |
Univera Setting Professional Modifier None Typical Low $24.55 Median $35.48 Typical High $74.13 | Professional | None | $24.55 | $35.48 | $74.13 |
7 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 $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
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 |
Where New York sits
The same service costs 6.5 times more in Arizona than in Hawaii. 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· 40th of 51
$67.61
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.