How much rates vary
Facilitymedian $550 · 10th to 90th $219 to $5,012Professionalmedian $219 · 10th to 90th $132 to $269
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 $239.88 Median $269.15 Typical High $269.15 | Facility | None | $239.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $269.15 | Professional | None | $213.80 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $107.15 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $47.86 Typical High $53.70 | Professional | 53 · Discontinued | $43.65 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $32.36 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.99 Typical High $26.92 | Professional | 56 · Pre-op care only | $21.88 | $23.99 | $26.92 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $501.19 | Professional | None | $302.00 | $398.11 | $501.19 |
Geisinger Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Geisinger Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $309.03 | Professional | None | $186.21 | $239.88 | $309.03 |
Martin's Point Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Martin's Point Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $269.15 | Professional | None | $218.78 | $239.88 | $269.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $109.65 | $120.23 | $134.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $47.86 Typical High $53.70 | Professional | 53 · Discontinued | $43.65 | $47.86 | $53.70 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $32.36 | $35.48 | $39.81 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.99 Typical High $26.92 | Professional | 56 · Pre-op care only | $21.88 | $23.99 | $26.92 |
Oscar Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
UPMC Health Plan Setting Facility Modifier None Typical Low $218.78 Median $1,000.00 Typical High $1,698.24 | Facility | None | $218.78 | $1,000.00 | $1,698.24 |
UPMC Health Plan Setting Professional Modifier None Typical Low $213.80 Median $218.78 Typical High $288.40 | Professional | None | $213.80 | $218.78 | $288.40 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $436.52 | Facility | None | $363.08 | $363.08 | $436.52 |
United Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $165.96 | Professional | None | $138.04 | $151.36 | $165.96 |
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 3.2 times more in Minnesota than in New York. 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· 22nd of 51
$219
MN $363NY $115
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.