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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | None | $45.71 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $87.10 | Professional | None | $69.18 | $69.18 | $87.10 |
Hally Health Setting Professional Modifier None Typical Low $36.31 Median $60.26 Typical High $61.66 | Professional | None | $36.31 | $60.26 | $61.66 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $70.79 Typical High $151.36 | Facility | None | $63.10 | $70.79 | $151.36 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $30.90 Typical High $354.81 | Professional | None | $26.92 | $30.90 | $354.81 |
Midlands Setting Professional Modifier None Typical Low $57.54 Median $123.03 Typical High $123.03 | Professional | None | $57.54 | $123.03 | $123.03 |
Oscar Health Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $128.82 | Professional | None | $63.10 | $89.13 | $128.82 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $169.82 | Facility | None | $87.10 | $87.10 | $169.82 |
United Setting Professional Modifier None Typical Low $12.02 Median $30.90 Typical High $35.48 | Professional | None | $12.02 | $30.90 | $35.48 |
Wellmark Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $22.91 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $22.91 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $9.12 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $6.92 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.57 | $5.25 | $5.25 |
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 3.9 times more in Montana than in Alaska. 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· 10th of 51
$50.12
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.