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 $47.86 Median $47.86 Typical High $54.95 | Facility | None | $47.86 | $47.86 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $100.00 | Professional | None | $47.86 | $47.86 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $23.99 Typical High $50.12 | Professional | 52 · Reduced service | $23.99 | $23.99 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $19.95 | Professional | 53 · Discontinued | $9.55 | $9.55 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $15.14 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $223.87 | Professional | None | $177.83 | $223.87 | $223.87 |
Horizon BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | None | $134.90 | $134.90 | $138.04 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $169.82 | Facility | None | $144.54 | $144.54 | $169.82 |
United Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $102.33 | Professional | None | $83.18 | $95.50 | $102.33 |
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 2.5 times more in Minnesota 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.
New Jersey· 35th of 51
$89.13
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.