How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $125.89 Median $162.18 Typical High $162.18 | Professional | None | $125.89 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $63.10 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $25.12 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $19.05 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $229.09 | Professional | None | $72.44 | $72.44 | $229.09 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $831.76 | Facility | None | $169.82 | $302.00 | $831.76 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $954.99 | Professional | None | $75.86 | $97.72 | $954.99 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $97.72 | Professional | None | $72.44 | $97.72 | $97.72 |
2 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 |
|---|---|---|---|---|---|
Oscar Health 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 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 Nebraska sits
The same service costs 2.6 times more in Montana than in Ohio. 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.
Nebraska· 38th of 51
$97.72
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.