How much rates vary
Facilitymedian $288 · 10th to 90th $117 to $5,012Professionalmedian $115 · 10th to 90th $62 to $141
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 $125.89 Median $141.25 Typical High $141.25 | Facility | None | $125.89 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $141.25 | Professional | None | $104.71 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $63.10 Typical High $70.79 | Professional | 52 · Reduced service | $52.48 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.12 Typical High $28.84 | Professional | 53 · Discontinued | $20.89 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $21.38 | Professional | 55 · Aftercare only | $15.85 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.59 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.47 | $12.59 | $14.13 |
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 $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 $186.21 Median $245.47 Typical High $316.23 | Professional | None | $186.21 | $245.47 | $316.23 |
Geisinger Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Geisinger Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $165.96 | Professional | None | $100.00 | $117.49 | $165.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Martin's Point Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $141.25 | Professional | None | $109.65 | $125.89 | $141.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $63.10 Typical High $70.79 | Professional | 52 · Reduced service | $54.95 | $63.10 | $70.79 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $25.12 Typical High $28.84 | Professional | 53 · Discontinued | $21.88 | $25.12 | $28.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.05 Typical High $21.38 | Professional | 55 · Aftercare only | $16.22 | $19.05 | $21.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.59 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.96 | $12.59 | $14.13 |
Oscar Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
UPMC Health Plan Setting Facility Modifier None Typical Low $117.49 Median $524.81 Typical High $912.01 | Facility | None | $117.49 | $524.81 | $912.01 |
UPMC Health Plan Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $154.88 | Professional | None | $112.20 | $117.49 | $154.88 |
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 $74.13 Median $81.28 Typical High $87.10 | Professional | None | $74.13 | $81.28 | $87.10 |
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 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.
Pennsylvania· 11th of 51
$115
MN $151UT $61.66
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.