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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | None | $74.13 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $151.36 | Professional | None | $107.15 | $123.03 | $151.36 |
Hally Health Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $107.15 | Professional | None | $79.43 | $93.33 | $107.15 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $123.03 Typical High $257.04 | Facility | None | $102.33 | $123.03 | $257.04 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $602.56 | Professional | None | $42.66 | $45.71 | $602.56 |
Midlands Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $181.97 | Professional | None | $102.33 | $181.97 | $181.97 |
Oscar Health Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $199.53 | Professional | None | $102.33 | $151.36 | $199.53 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $288.40 | Facility | None | $151.36 | $151.36 | $288.40 |
United Setting Professional Modifier None Typical Low $15.14 Median $45.71 Typical High $47.86 | Professional | None | $15.14 | $45.71 | $47.86 |
Wellmark Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
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 $37.15 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $37.15 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $14.79 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $11.22 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.41 | $7.76 | $7.76 |
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 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· 22nd of 51
$75.86
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.