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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | None | $77.62 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $138.04 | Professional | None | $112.20 | $112.20 | $138.04 |
Hally Health Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $112.20 | Professional | None | $81.28 | $95.50 | $112.20 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $269.15 | Facility | None | $104.71 | $128.82 | $269.15 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $47.86 Typical High $630.96 | Professional | None | $44.67 | $47.86 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $190.55 | Professional | None | $104.71 | $190.55 | $190.55 |
Oscar Health Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $208.93 | Professional | None | $97.72 | $138.04 | $208.93 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $302.00 | Facility | None | $158.49 | $158.49 | $302.00 |
United Setting Professional Modifier None Typical Low $15.14 Median $47.86 Typical High $52.48 | Professional | None | $15.14 | $47.86 | $52.48 |
Wellmark Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
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 $38.90 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $38.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $15.49 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.76 | $8.13 | $8.13 |
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 2.5 times more in Montana than in Missouri. 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
$77.62
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.