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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $58.88 | Professional | None | $53.70 | $56.23 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $125.89 | Professional | None | $77.62 | $102.33 | $125.89 |
Hally Health Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $87.10 | Professional | None | $56.23 | $66.07 | $87.10 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $77.62 Typical High $173.78 | Facility | None | $45.71 | $77.62 | $173.78 |
Medica Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $436.52 | Professional | None | $30.90 | $33.11 | $436.52 |
Midlands Setting Professional Modifier None Typical Low $66.07 Median $131.83 Typical High $131.83 | Professional | None | $66.07 | $131.83 | $131.83 |
Oscar Health Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $158.49 | Professional | None | $74.13 | $114.82 | $158.49 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $208.93 | Facility | None | $109.65 | $109.65 | $208.93 |
United Setting Professional Modifier None Typical Low $10.00 Median $33.11 Typical High $33.11 | Professional | None | $10.00 | $33.11 | $33.11 |
Wellmark Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $26.92 Median $28.18 Typical High $29.51 | Professional | 52 · Reduced service | $26.92 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $11.48 Typical High $11.75 | Professional | 53 · Discontinued | $10.72 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.51 Typical High $8.71 | Professional | 55 · Aftercare only | $8.13 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.62 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.37 | $5.62 | $5.89 |
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 2.7 times more in Hawaii than in Alabama. 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· 20th of 51
$54.95
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.