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 $123.03 Median $3,890.45 Typical High $18,620.87 | Facility | None | $123.03 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $120.23 Typical High $123.03 | Professional | None | $64.57 | $120.23 | $123.03 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $47.86 Median $912.01 Typical High $1,445.44 | Facility | None | $47.86 | $912.01 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $467.74 | Facility | None | $85.11 | $102.33 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $158.49 | Professional | None | $69.18 | $109.65 | $158.49 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $158.49 Typical High $1,288.25 | Facility | None | $75.86 | $158.49 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $446.68 Typical High $851.14 | Professional | None | $104.71 | $446.68 | $851.14 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,380.38 | Facility | None | $89.13 | $616.60 | $1,380.38 |
United Setting Professional Modifier None Typical Low $53.70 Median $93.33 Typical High $165.96 | Professional | None | $53.70 | $93.33 | $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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $32.36 Typical High $60.26 | Professional | 52 · Reduced service | $31.62 | $32.36 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $24.55 | Professional | 53 · Discontinued | $12.88 | $12.88 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $48.98 Typical High $91.20 | Professional | 54 · Surgery only | $47.86 | $48.98 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.77 Typical High $18.20 | Professional | 55 · Aftercare only | $9.55 | $9.77 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $12.30 |
Where Oklahoma sits
The same service costs 3.9 times more in Wisconsin than in Kentucky. 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· 19th of 51
$126
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.