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 $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $45.71 | Professional | None | $43.65 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $83.18 | Professional | None | $63.10 | $66.07 | $83.18 |
Hally Health Setting Professional Modifier None Typical Low $45.71 Median $53.70 Typical High $58.88 | Professional | None | $45.71 | $53.70 | $58.88 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $61.66 Typical High $141.25 | Facility | None | $37.15 | $61.66 | $141.25 |
Medica Setting Professional Modifier None Typical Low $24.55 Median $26.92 Typical High $338.84 | Professional | None | $24.55 | $26.92 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $56.23 Median $107.15 Typical High $107.15 | Professional | None | $56.23 | $107.15 | $107.15 |
Oscar Health Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $117.49 | Professional | None | $57.54 | $81.28 | $117.49 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $169.82 | Facility | None | $87.10 | $87.10 | $169.82 |
United Setting Professional Modifier None Typical Low $10.00 Median $26.92 Typical High $30.20 | Professional | None | $10.00 | $26.92 | $30.20 |
Wellmark Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
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 $21.88 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $21.88 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $9.33 | Professional | 53 · Discontinued | $8.71 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.61 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.37 | $4.57 | $4.57 |
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 3.3 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· 23rd of 51
$43.65
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.