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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | None | $60.26 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | None | $97.72 | $97.72 | $120.23 |
Hally Health Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $93.33 | Professional | None | $63.10 | $83.18 | $93.33 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $177.83 | Facility | None | $74.13 | $95.50 | $177.83 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $416.87 | Professional | None | $31.62 | $41.69 | $416.87 |
Midlands Setting Professional Modifier None Typical Low $70.79 Median $165.96 Typical High $165.96 | Professional | None | $70.79 | $165.96 | $165.96 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $181.97 | Professional | None | $85.11 | $120.23 | $181.97 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $199.53 | Facility | None | $102.33 | $102.33 | $199.53 |
United Setting Professional Modifier None Typical Low $15.14 Median $41.69 Typical High $44.67 | Professional | None | $15.14 | $41.69 | $44.67 |
Wellmark Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
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 $30.20 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $30.20 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $12.02 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $9.12 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.03 | $7.08 | $7.08 |
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 4.2 times more in Minnesota than in Alaska. 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· 5th of 51
$69.18
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.