How much rates vary
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 $100.00 Median $1,621.81 Typical High $6,760.83 | Facility | None | $100.00 | $1,621.81 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $144.54 Typical High $199.53 | Professional | None | $64.57 | $144.54 | $199.53 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $66.07 Median $147.91 Typical High $251.19 | Professional | None | $66.07 | $147.91 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $158.49 Typical High $229.09 | Professional | None | $79.43 | $158.49 | $229.09 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $218.78 Typical High $1,548.82 | Facility | None | $95.50 | $218.78 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $794.33 Typical High $2,691.53 | Professional | None | $169.82 | $794.33 | $2,691.53 |
United Setting Facility Modifier None Typical Low $165.96 Median $891.25 Typical High $1,548.82 | Facility | None | $165.96 | $891.25 | $1,548.82 |
United Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $257.04 | Professional | None | $63.10 | $138.04 | $257.04 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $56.23 Typical High $100.00 | Professional | 52 · Reduced service | $35.48 | $56.23 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $22.39 Typical High $39.81 | Professional | 53 · Discontinued | $14.13 | $22.39 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $85.11 Typical High $151.36 | Professional | 54 · Surgery only | $52.48 | $85.11 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.98 Typical High $30.20 | Professional | 55 · Aftercare only | $10.47 | $16.98 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $7.08 | $11.22 | $19.95 |
Where Oklahoma sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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.
Oklahoma· 13th of 51
$200
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.