How much rates vary
Facilitymedian $269 · 10th to 90th $263 to $324Professionalmedian $263 · 10th to 90th $145 to $309
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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | None | $263.03 | $263.03 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | None | $165.96 | $263.03 | $263.03 |
CDPHP Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $288.40 Typical High $707.95 | Facility | None | $165.96 | $288.40 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $1,380.38 | Professional | None | $288.40 | $288.40 | $1,380.38 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $446.68 | Facility | None | $275.42 | $275.42 | $446.68 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Excellus BCBS Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | None | $269.15 | $269.15 | $295.12 |
MVP Health Care Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
MVP Health Care Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $346.74 | Professional | None | $257.04 | $302.00 | $346.74 |
Univera Setting Facility Modifier None Typical Low $93.33 Median $269.15 Typical High $269.15 | Facility | None | $93.33 | $269.15 | $269.15 |
Univera Setting Professional Modifier None Typical Low $93.33 Median $269.15 Typical High $295.12 | Professional | None | $93.33 | $269.15 | $295.12 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
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 3.9 times more in Arizona than in Montana. 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· 37th of 51
$263
AZ $407MT $105
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.