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 $51.29 | Professional | None | $47.86 | $50.12 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $93.33 | Professional | None | $69.18 | $74.13 | $93.33 |
Hally Health Setting Professional Modifier None Typical Low $50.12 Median $58.88 Typical High $64.57 | Professional | None | $50.12 | $58.88 | $64.57 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $67.61 Typical High $151.36 | Facility | None | $39.81 | $67.61 | $151.36 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $371.54 | Professional | None | $26.92 | $29.51 | $371.54 |
Midlands Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $117.49 | Professional | None | $60.26 | $117.49 | $117.49 |
Oscar Health Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $128.82 | Professional | None | $64.57 | $91.20 | $128.82 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $186.21 | Facility | None | $95.50 | $95.50 | $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 $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
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 $25.70 | Professional | 52 · Reduced service | $23.99 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.00 Typical High $10.23 | Professional | 53 · Discontinued | $9.55 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.41 Typical High $7.76 | Professional | 55 · Aftercare only | $7.08 | $7.41 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.01 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.79 | $5.01 | $5.13 |
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 2.6 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· 26th of 51
$47.86
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.