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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | None | $83.18 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $147.91 | Professional | None | $117.49 | $117.49 | $147.91 |
Hally Health Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $117.49 | Professional | None | $87.10 | $102.33 | $117.49 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $117.49 Typical High $263.03 | Facility | None | $70.79 | $117.49 | $263.03 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $616.60 | Professional | None | $47.86 | $51.29 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $204.17 | Professional | None | $107.15 | $204.17 | $204.17 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $223.87 | Professional | None | $104.71 | $147.91 | $223.87 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $316.23 | Facility | None | $162.18 | $162.18 | $316.23 |
United Setting Professional Modifier None Typical Low $12.02 Median $51.29 Typical High $51.29 | Professional | None | $12.02 | $51.29 | $51.29 |
Wellmark Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
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 $41.69 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $41.69 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $16.60 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $12.30 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.32 | $8.71 | $8.71 |
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 Hawaii 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· 18th of 51
$85.11
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.