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 $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $34.67 | Professional | None | $33.11 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $67.61 | Professional | None | $47.86 | $54.95 | $67.61 |
Hally Health Setting Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $47.86 | Professional | None | $34.67 | $40.74 | $47.86 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $46.77 Typical High $107.15 | Facility | None | $28.18 | $46.77 | $107.15 |
Medica Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $263.03 | Professional | None | $18.62 | $20.42 | $263.03 |
Midlands Setting Professional Modifier None Typical Low $44.67 Median $81.28 Typical High $81.28 | Professional | None | $44.67 | $81.28 | $81.28 |
Oscar Health Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $89.13 | Professional | None | $44.67 | $67.61 | $89.13 |
United Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $128.82 | Facility | None | $66.07 | $66.07 | $128.82 |
United Setting Professional Modifier None Typical Low $10.00 Median $20.42 Typical High $25.12 | Professional | None | $10.00 | $20.42 | $25.12 |
Wellmark Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $16.60 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $16.60 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.61 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $5.01 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.31 | $3.47 | $3.47 |
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 3.2 times more in Montana than in Indiana. 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· 24th of 51
$33.11
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.