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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $53.70 | Professional | None | $50.12 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $91.20 | Professional | None | $72.44 | $72.44 | $91.20 |
Hally Health Setting Professional Modifier None Typical Low $51.29 Median $63.10 Typical High $70.79 | Professional | None | $51.29 | $63.10 | $70.79 |
Medica Setting Facility Modifier None Typical Low $43.65 Median $72.44 Typical High $158.49 | Facility | None | $43.65 | $72.44 | $158.49 |
Medica Setting Professional Modifier None Typical Low $29.51 Median $31.62 Typical High $398.11 | Professional | None | $29.51 | $31.62 | $398.11 |
Midlands Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $125.89 | Professional | None | $64.57 | $125.89 | $125.89 |
Oscar Health Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $138.04 | Professional | None | $64.57 | $91.20 | $138.04 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $194.98 | Facility | None | $100.00 | $100.00 | $194.98 |
United Setting Professional Modifier None Typical Low $12.02 Median $31.62 Typical High $34.67 | Professional | None | $12.02 | $31.62 | $34.67 |
Wellmark Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
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 $24.55 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $24.55 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.00 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.41 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.01 | $5.37 | $5.37 |
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 Montana than in Ohio. 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
$52.48
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.