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 $125.89 Median $2,454.71 Typical High $7,585.78 | Facility | None | $125.89 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $107.15 Typical High $125.89 | Professional | None | $57.54 | $107.15 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $100.00 Typical High $112.20 | Professional | None | $52.48 | $100.00 | $112.20 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $575.44 Median $776.25 Typical High $1,071.52 | Facility | None | $575.44 | $776.25 | $1,071.52 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $125.89 | Professional | None | $61.66 | $91.20 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $467.74 | Facility | None | $70.79 | $83.18 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $144.54 | Professional | None | $64.57 | $95.50 | $144.54 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $123.03 Typical High $1,174.90 | Facility | None | $72.44 | $123.03 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $588.84 Typical High $724.44 | Professional | None | $97.72 | $588.84 | $724.44 |
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 $48.98 Median $89.13 Typical High $154.88 | Professional | None | $48.98 | $89.13 | $154.88 |
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 $28.84 Median $29.51 Typical High $53.70 | Professional | 52 · Reduced service | $28.84 | $29.51 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.75 Typical High $21.88 | Professional | 53 · Discontinued | $11.48 | $11.75 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $43.65 Typical High $81.28 | Professional | 54 · Surgery only | $42.66 | $43.65 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $16.22 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.89 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.75 | $5.89 | $10.96 |
Where Oklahoma sits
The same service costs 2.8 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· 18th of 51
$120
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.