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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | None | $75.86 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | None | $107.15 | $107.15 | $134.90 |
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 $125.89 Typical High $263.03 | Facility | None | $102.33 | $125.89 | $263.03 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $524.81 | Professional | None | $42.66 | $46.77 | $524.81 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $186.21 | Professional | None | $104.71 | $186.21 | $186.21 |
Oscar Health Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $204.17 | Professional | None | $95.50 | $134.90 | $204.17 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $295.12 | Facility | None | $151.36 | $151.36 | $295.12 |
United Setting Professional Modifier None Typical Low $15.14 Median $46.77 Typical High $48.98 | Professional | None | $15.14 | $46.77 | $48.98 |
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 $38.02 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $38.02 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.14 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $11.22 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.59 | $7.94 | $7.94 |
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 2.3 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· 20th 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.