How much rates vary
Facilitymedian $457 · 10th to 90th $182 to $5,012Professionalmedian $182 · 10th to 90th $107 to $257
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 $199.53 Median $223.87 Typical High $223.87 | Facility | None | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $223.87 | Professional | None | $177.83 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $100.00 Typical High $112.20 | Professional | 52 · Reduced service | $91.20 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $39.81 Typical High $44.67 | Professional | 53 · Discontinued | $36.31 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $22.39 |
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 |
Capital Blue Cross Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $323.59 Median $426.58 Typical High $549.54 | Professional | None | $323.59 | $426.58 | $549.54 |
Geisinger Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Geisinger Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $263.03 | Professional | None | $158.49 | $204.17 | $263.03 |
Highmark BCBS Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Martin's Point Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Martin's Point Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $223.87 | Professional | None | $181.97 | $199.53 | $223.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $100.00 Typical High $112.20 | Professional | 52 · Reduced service | $91.20 | $100.00 | $112.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $39.81 Typical High $44.67 | Professional | 53 · Discontinued | $36.31 | $39.81 | $44.67 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $33.88 | Professional | 55 · Aftercare only | $27.54 | $30.20 | $33.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $22.39 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $22.39 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
UPMC Health Plan Setting Facility Modifier None Typical Low $181.97 Median $831.76 Typical High $1,445.44 | Facility | None | $181.97 | $831.76 | $1,445.44 |
UPMC Health Plan Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $245.47 | Professional | None | $177.83 | $181.97 | $245.47 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $354.81 | Facility | None | $295.12 | $295.12 | $354.81 |
United Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | None | $114.82 | $128.82 | $138.04 |
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 2.8 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.
Pennsylvania· 19th of 51
$186
MN $295UT $107
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.