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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | None | $60.26 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $104.71 | Professional | None | $83.18 | $83.18 | $104.71 |
Hally Health Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $85.11 | Professional | None | $61.66 | $74.13 | $85.11 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $85.11 Typical High $186.21 | Facility | None | $51.29 | $85.11 | $186.21 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $37.15 Typical High $446.68 | Professional | None | $34.67 | $37.15 | $446.68 |
Midlands Setting Professional Modifier None Typical Low $74.13 Median $147.91 Typical High $147.91 | Professional | None | $74.13 | $147.91 | $147.91 |
Oscar Health Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $154.88 | Professional | None | $75.86 | $107.15 | $154.88 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $223.87 | Facility | None | $117.49 | $117.49 | $223.87 |
United Setting Professional Modifier None Typical Low $12.02 Median $37.15 Typical High $40.74 | Professional | None | $12.02 | $37.15 | $40.74 |
Wellmark Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $30.20 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $30.20 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $12.02 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $9.12 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $6.31 |
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 2.9 times more in Hawaii 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· 17th of 51
$61.66
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.