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 $630.96 Median $2,511.89 Typical High $7,585.78 | Facility | None | $630.96 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $85.11 Typical High $107.15 | Professional | None | $34.67 | $85.11 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $89.13 | Professional | None | $75.86 | $85.11 | $89.13 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $2,691.53 | Facility | None | $1,047.13 | $1,737.80 | $2,691.53 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $38.02 Median $75.86 Typical High $102.33 | Professional | None | $38.02 | $75.86 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $64.57 Typical High $100.00 | Facility | None | $52.48 | $64.57 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $117.49 | Professional | None | $40.74 | $79.43 | $117.49 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $112.20 Typical High $1,174.90 | Facility | None | $60.26 | $112.20 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $288.40 Typical High $660.69 | Professional | None | $77.62 | $288.40 | $660.69 |
United Setting Facility Modifier None Typical Low $89.13 Median $602.56 Typical High $1,380.38 | Facility | None | $89.13 | $602.56 | $1,380.38 |
United Setting Professional Modifier None Typical Low $30.90 Median $61.66 Typical High $117.49 | Professional | None | $30.90 | $61.66 | $117.49 |
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 $17.38 Median $17.78 Typical High $42.66 | Professional | 52 · Reduced service | $17.38 | $17.78 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $7.08 Typical High $16.98 | Professional | 53 · Discontinued | $6.92 | $7.08 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $26.30 Typical High $64.57 | Professional | 54 · Surgery only | $25.70 | $26.30 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $12.88 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.55 Typical High $8.51 | Professional | 56 · Pre-op care only | $3.47 | $3.55 | $8.51 |
Where Oklahoma sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 10th of 51
$102
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.