How much rates vary
Facilitymedian $501 · 10th to 90th $200 to $5,012Professionalmedian $200 · 10th to 90th $110 to $245
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 $218.78 Median $245.47 Typical High $245.47 | Facility | None | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $245.47 | Professional | None | $186.21 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $91.20 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $37.15 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.11 Typical High $37.15 | Professional | 55 · Aftercare only | $27.54 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $18.62 | $21.88 | $24.55 |
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 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $562.34 | Professional | None | $338.84 | $446.68 | $562.34 |
Geisinger Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Geisinger Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $288.40 | Professional | None | $169.82 | $218.78 | $288.40 |
Martin's Point Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $245.47 | Professional | None | $199.53 | $218.78 | $245.47 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $97.72 | $109.65 | $123.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $39.81 | $43.65 | $48.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.11 Typical High $37.15 | Professional | 55 · Aftercare only | $29.51 | $33.11 | $37.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.95 | $21.88 | $24.55 |
Oscar Health Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
UPMC Health Plan Setting Facility Modifier None Typical Low $199.53 Median $912.01 Typical High $1,548.82 | Facility | None | $199.53 | $912.01 | $1,548.82 |
UPMC Health Plan Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $269.15 | Professional | None | $194.98 | $199.53 | $269.15 |
United Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $371.54 | Facility | None | $309.03 | $309.03 | $371.54 |
United Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $151.36 | Professional | None | $125.89 | $141.25 | $151.36 |
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 2.5 times more in Alaska than in Utah. 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· 13th of 51
$200
AK $269UT $110
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.