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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $50.12 Typical High $52.48 | Professional | None | $47.86 | $50.12 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $91.20 Typical High $114.82 | Professional | None | $69.18 | $91.20 | $114.82 |
Hally Health Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $79.43 | Professional | None | $56.23 | $66.07 | $79.43 |
Medica Setting Facility Modifier None Typical Low $40.74 Median $69.18 Typical High $154.88 | Facility | None | $40.74 | $69.18 | $154.88 |
Medica Setting Professional Modifier None Typical Low $27.54 Median $29.51 Typical High $371.54 | Professional | None | $27.54 | $29.51 | $371.54 |
Midlands Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $117.49 | Professional | None | $64.57 | $117.49 | $117.49 |
Oscar Health Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $144.54 | Professional | None | $66.07 | $102.33 | $144.54 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $186.21 | Facility | None | $97.72 | $97.72 | $186.21 |
United Setting Professional Modifier None Typical Low $10.00 Median $29.51 Typical High $30.20 | Professional | None | $10.00 | $29.51 | $30.20 |
Wellmark Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $23.99 Median $25.12 Typical High $26.30 | Professional | 52 · Reduced service | $23.99 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.00 Typical High $10.72 | Professional | 53 · Discontinued | $9.55 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.59 Typical High $7.94 | Professional | 55 · Aftercare only | $7.24 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.01 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.79 | $5.01 | $5.25 |
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 2.8 times more in Hawaii than in Utah. 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
$48.98
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.