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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | None | $72.44 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $154.88 | Professional | None | $104.71 | $123.03 | $154.88 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $120.23 | Professional | None | $75.86 | $89.13 | $120.23 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $102.33 Typical High $229.09 | Facility | None | $60.26 | $102.33 | $229.09 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $588.84 | Professional | None | $40.74 | $44.67 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $177.83 Typical High $177.83 | Professional | None | $93.33 | $177.83 | $177.83 |
Oscar Health Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $194.98 | Professional | None | $97.72 | $151.36 | $194.98 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $281.84 | Facility | None | $144.54 | $144.54 | $281.84 |
United Setting Professional Modifier None Typical Low $10.00 Median $44.67 Typical High $44.67 | Professional | None | $10.00 | $44.67 | $44.67 |
Wellmark Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
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 $36.31 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $36.31 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $14.45 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.24 | $7.59 | $7.59 |
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 3.5 times more in Hawaii than in New York. 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· 19th of 51
$72.44
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.