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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | None | $104.71 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $186.21 | Professional | None | $151.36 | $151.36 | $186.21 |
Hally Health Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $151.36 | Professional | None | $109.65 | $128.82 | $151.36 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $173.78 Typical High $363.08 | Facility | None | $141.25 | $173.78 | $363.08 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $707.95 | Professional | None | $58.88 | $64.57 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $125.89 Median $257.04 Typical High $257.04 | Professional | None | $125.89 | $257.04 | $257.04 |
Oscar Health Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $281.84 | Professional | None | $131.83 | $186.21 | $281.84 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $407.38 | Facility | None | $208.93 | $208.93 | $407.38 |
United Setting Professional Modifier None Typical Low $15.14 Median $64.57 Typical High $64.57 | Professional | None | $15.14 | $64.57 | $64.57 |
Wellmark Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
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 $52.48 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $52.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $20.89 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.47 | $10.96 | $10.96 |
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
$105
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.