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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $32.36 | Professional | None | $28.84 | $28.84 | $32.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $29.51 | Facility | None | $28.84 | $28.84 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $50.12 | Professional | None | $28.84 | $28.84 | $50.12 |
CDPHP Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $31.62 Typical High $102.33 | Facility | None | $28.84 | $31.62 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $154.88 | Professional | None | $31.62 | $31.62 | $154.88 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $32.36 Typical High $69.18 | Facility | None | $0.10 | $32.36 | $69.18 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $36.31 | Professional | None | $30.90 | $30.90 | $36.31 |
Excellus BCBS Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $32.36 | Professional | None | $30.20 | $30.20 | $32.36 |
MVP Health Care Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
MVP Health Care Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | None | $23.99 | $23.99 | $33.11 |
United Setting Facility Modifier None Typical Low $28.84 Median $30.90 Typical High $33.88 | Facility | None | $28.84 | $30.90 | $33.88 |
United Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $48.98 | Professional | None | $32.36 | $38.02 | $48.98 |
Univera Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $31.62 | Facility | None | $30.20 | $30.20 | $31.62 |
Univera Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $32.36 | Professional | None | $30.20 | $30.20 | $32.36 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
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 1.6 times more in Arizona than in Georgia. 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
$30.20
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.