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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $208.93 | Professional | None | $181.97 | $181.97 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
CDPHP Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $199.53 Typical High $588.84 | Facility | None | $158.49 | $199.53 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $954.99 | Professional | None | $199.53 | $199.53 | $954.99 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $151.36 Typical High $295.12 | Facility | None | $0.10 | $151.36 | $295.12 |
Emblem Health Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $190.55 | Professional | None | $87.10 | $190.55 | $190.55 |
Excellus BCBS Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | None | $186.21 | $186.21 | $199.53 |
Highmark BCBS Setting Facility Modifier None Typical Low $93.33 Median $229.09 Typical High $245.47 | Facility | None | $93.33 | $229.09 | $245.47 |
Highmark BCBS Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $234.42 | Professional | None | $218.78 | $229.09 | $234.42 |
MVP Health Care Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
MVP Health Care Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $234.42 | Professional | None | $165.96 | $204.17 | $234.42 |
Univera Setting Facility Modifier None Typical Low $114.82 Median $186.21 Typical High $186.21 | Facility | None | $114.82 | $186.21 | $186.21 |
Univera Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $223.87 | Professional | None | $114.82 | $186.21 | $223.87 |
4 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 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
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 562.3 times more in Montana than in Rhode Island. 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· 45th of 51
$182
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.