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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $61.66 | Professional | None | $56.23 | $58.88 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $134.90 | Professional | None | $81.28 | $107.15 | $134.90 |
Hally Health Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $93.33 | Professional | None | $58.88 | $69.18 | $93.33 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $79.43 Typical High $181.97 | Facility | None | $47.86 | $79.43 | $181.97 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $34.67 Typical High $467.74 | Professional | None | $32.36 | $34.67 | $467.74 |
Midlands Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $138.04 | Professional | None | $72.44 | $138.04 | $138.04 |
Oscar Health Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $169.82 | Professional | None | $77.62 | $120.23 | $169.82 |
United Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $218.78 | Facility | None | $114.82 | $114.82 | $218.78 |
United Setting Professional Modifier None Typical Low $10.00 Median $34.67 Typical High $37.15 | Professional | None | $10.00 | $34.67 | $37.15 |
Wellmark Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
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 $28.18 Median $29.51 Typical High $30.20 | Professional | 52 · Reduced service | $28.18 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $12.30 | Professional | 53 · Discontinued | $11.22 | $11.75 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $9.12 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.89 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.62 | $5.89 | $6.17 |
Oscar Health Setting Professional Modifier GX · Voluntary liability notice Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | GX · Voluntary liability notice | $15.14 | $15.14 | $15.14 |
Oscar Health Setting Professional Modifier LO Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | LO | $30.20 | $30.20 | $30.20 |
Oscar Health Setting Professional Modifier PL · Progressive lenses Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | PL · Progressive lenses | $15.14 | $15.14 | $15.14 |
Where Iowa sits
The same service costs 3.1 times more in Montana than in New York. 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.
Iowa· 21st of 51
$56.23
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.