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 $57.54 Median $57.54 Typical High $64.57 | Facility | None | $57.54 | $57.54 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $109.65 | Professional | None | $57.54 | $57.54 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $28.84 Typical High $54.95 | Professional | 52 · Reduced service | $28.84 | $28.84 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $21.88 | Professional | 53 · Discontinued | $11.48 | $11.48 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $16.22 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Emblem Health Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $263.03 | Professional | None | $213.80 | $263.03 | $263.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | None | $162.18 | $162.18 | $165.96 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $204.17 | Facility | None | $169.82 | $169.82 | $204.17 |
United Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $120.23 | Professional | None | $97.72 | $112.20 | $120.23 |
4 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 |
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 New Jersey 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.
New Jersey· 33rd 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.