How much rates vary
Facilitymedian $234 · 10th to 90th $93 to $5,012Professionalmedian $91 · 10th to 90th $48 to $129
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 $102.33 Median $114.82 Typical High $114.82 | Facility | None | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $114.82 | Professional | None | $81.28 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $50.12 Typical High $57.54 | Professional | 52 · Reduced service | $39.81 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $20.42 Typical High $22.91 | Professional | 53 · Discontinued | $16.22 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $12.02 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.94 | $10.23 | $11.48 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Emblem Health Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $245.47 | Professional | None | $144.54 | $190.55 | $245.47 |
Geisinger Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Geisinger Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $131.83 | Professional | None | $79.43 | $102.33 | $131.83 |
Martin's Point Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $114.82 | Professional | None | $85.11 | $102.33 | $114.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $50.12 Typical High $57.54 | Professional | 52 · Reduced service | $42.66 | $50.12 | $57.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $20.42 Typical High $22.91 | Professional | 53 · Discontinued | $16.98 | $20.42 | $22.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $12.88 | $15.14 | $16.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.51 | $10.23 | $11.48 |
Oscar Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
UPMC Health Plan Setting Facility Modifier None Typical Low $93.33 Median $426.58 Typical High $724.44 | Facility | None | $93.33 | $426.58 | $724.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $123.03 | Professional | None | $89.13 | $93.33 | $123.03 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $158.49 | Facility | None | $131.83 | $131.83 | $158.49 |
United Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $70.79 | Professional | None | $58.88 | $64.57 | $70.79 |
5 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 |
|---|---|---|---|---|---|
AmeriHealth Setting Professional Modifier PL · Progressive lenses Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | PL · Progressive lenses | $60.26 | $60.26 | $60.26 |
Independence Blue Cross Setting Professional Modifier PL · Progressive lenses Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | PL · Progressive lenses | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Pennsylvania sits
The same service costs 2.6 times more in Hawaii than in Indiana. 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.
Pennsylvania· 10th of 51
$93.33
HI $126IN $47.86
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.