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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | None | $63.10 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $120.23 | Professional | None | $89.13 | $95.50 | $120.23 |
Hally Health Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $85.11 | Professional | None | $66.07 | $77.62 | $85.11 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $213.80 | Facility | None | $85.11 | $102.33 | $213.80 |
Medica Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $467.74 | Professional | None | $35.48 | $38.02 | $467.74 |
Midlands Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $154.88 | Professional | None | $85.11 | $154.88 | $154.88 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $165.96 | Professional | None | $85.11 | $117.49 | $165.96 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $239.88 | Facility | None | $125.89 | $125.89 | $239.88 |
United Setting Professional Modifier None Typical Low $15.14 Median $38.02 Typical High $44.67 | Professional | None | $15.14 | $38.02 | $44.67 |
Wellmark Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
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 $30.90 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $30.90 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $12.59 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.31 | $6.61 | $6.61 |
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 2.7 times more in Hawaii than in Utah. 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· 21st of 51
$63.10
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.