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 $83.18 Median $83.18 Typical High $95.50 | Facility | None | $83.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $169.82 | Professional | None | $83.18 | $83.18 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $41.69 Typical High $83.18 | Professional | 52 · Reduced service | $41.69 | $41.69 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $31.62 | Professional | 53 · Discontinued | $16.60 | $16.60 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $25.12 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $389.05 | Professional | None | $309.03 | $389.05 | $389.05 |
Horizon BCBS Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $239.88 | Professional | None | $234.42 | $234.42 | $239.88 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $295.12 | Facility | None | $251.19 | $251.19 | $295.12 |
United Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $177.83 | Professional | None | $144.54 | $165.96 | $177.83 |
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 2.8 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· 31st of 51
$155
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.