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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $162.18 | Professional | None | $141.25 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $257.04 | Professional | None | $204.17 | $204.17 | $257.04 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $426.58 | Professional | None | $151.36 | $190.55 | $426.58 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $234.42 Typical High $489.78 | Facility | None | $204.17 | $234.42 | $489.78 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $1,778.28 | Professional | None | $87.10 | $95.50 | $1,778.28 |
Midlands Setting Professional Modifier None Typical Low $173.78 Median $380.19 Typical High $380.19 | Professional | None | $173.78 | $380.19 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $380.19 | Professional | None | $194.98 | $269.15 | $380.19 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $549.54 | Facility | None | $288.40 | $288.40 | $549.54 |
United Setting Professional Modifier None Typical Low $15.14 Median $95.50 Typical High $95.50 | Professional | None | $15.14 | $95.50 | $95.50 |
Wellmark Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $70.79 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $70.79 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $28.18 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $21.38 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $16.22 |
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 5.0 times more in Hawaii than in Florida. 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· 8th of 51
$155
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.