How much rates vary
Facilitymedian $107 · 10th to 90th $52 to $5,012Professionalmedian $76 · 10th to 90th $51 to $100
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 $56.23 Median $89.13 Typical High $1,412.54 | Facility | None | $56.23 | $89.13 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $100.00 | Professional | None | $52.48 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $33.88 Typical High $50.12 | Professional | 52 · Reduced service | $26.30 | $33.88 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $13.80 Typical High $19.95 | Professional | 53 · Discontinued | $10.47 | $13.80 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.23 Typical High $14.79 | Professional | 55 · Aftercare only | $7.94 | $10.23 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.92 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.25 | $6.92 | $10.00 |
AmeriHealth Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $229.09 | Professional | None | $114.82 | $181.97 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $75.86 Typical High $95.50 | Professional | None | $40.74 | $75.86 | $95.50 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Geisinger Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $66.07 | Professional | None | $19.95 | $19.95 | $66.07 |
Highmark BCBS Setting Facility Modifier None Typical Low $30.20 Median $31.62 Typical High $33.11 | Facility | None | $30.20 | $31.62 | $33.11 |
Highmark BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | None | $120.23 | $120.23 | $125.89 |
Independence Blue Cross Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Martin's Point Setting Facility Modifier None Typical Low $56.23 Median $100.00 Typical High $1,862.09 | Facility | None | $56.23 | $100.00 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $100.00 | Professional | None | $52.48 | $72.44 | $100.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $33.88 Typical High $50.12 | Professional | 52 · Reduced service | $26.30 | $33.88 | $50.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $13.80 Typical High $19.95 | Professional | 53 · Discontinued | $10.47 | $13.80 | $19.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $10.23 Typical High $14.79 | Professional | 55 · Aftercare only | $7.94 | $10.23 | $14.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.92 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.25 | $6.92 | $10.00 |
Oscar Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
UPMC Health Plan Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
UPMC Health Plan Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $39.81 Median $63.10 Typical High $107.15 | Professional | None | $39.81 | $63.10 | $107.15 |
18 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 |
|---|---|---|---|---|---|
AmeriHealth Setting Professional Modifier NDW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NDW | $60.26 | $60.26 | $60.26 |
AmeriHealth Setting Professional Modifier NES Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NES | $60.26 | $60.26 | $60.26 |
AmeriHealth Setting Professional Modifier NEW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NEW | $60.26 | $60.26 | $60.26 |
AmeriHealth Setting Professional Modifier NNW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NNW | $60.26 | $60.26 | $60.26 |
AmeriHealth Setting Professional Modifier PL · Progressive lenses Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | PL · Progressive lenses | $60.26 | $60.26 | $60.26 |
AmeriHealth Setting Professional Modifier SP · Ambulance S to P Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | SP · Ambulance S to P | $60.26 | $60.26 | $60.26 |
Independence Blue Cross Setting Professional Modifier NDW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NDW | $60.26 | $60.26 | $60.26 |
Independence Blue Cross Setting Professional Modifier NES Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NES | $60.26 | $60.26 | $60.26 |
Independence Blue Cross Setting Professional Modifier NEW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NEW | $60.26 | $60.26 | $60.26 |
Independence Blue Cross Setting Professional Modifier NNW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NNW | $60.26 | $60.26 | $60.26 |
Independence Blue Cross Setting Professional Modifier PL · Progressive lenses Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | PL · Progressive lenses | $60.26 | $60.26 | $60.26 |
Independence Blue Cross Setting Professional Modifier SP · Ambulance S to P Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | SP · Ambulance S to P | $60.26 | $60.26 | $60.26 |
Oscar Health Setting Professional Modifier NDW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NDW | $60.26 | $60.26 | $60.26 |
Oscar Health Setting Professional Modifier NES Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NES | $60.26 | $60.26 | $60.26 |
Oscar Health Setting Professional Modifier NEW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NEW | $60.26 | $60.26 | $60.26 |
Oscar Health Setting Professional Modifier NNW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NNW | $60.26 | $60.26 | $60.26 |
Oscar Health Setting Professional Modifier SP · Ambulance S to P Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | SP · Ambulance S to P | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Pennsylvania sits
The same service costs 3.0 times more in Alaska than in Florida. 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.
Pennsylvania· 33rd of 51
$75.86
AK $166FL $54.95
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.