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 $75.86 Median $3,801.89 Typical High $18,620.87 | Facility | None | $75.86 | $3,801.89 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $97.72 | Professional | None | $46.77 | $75.86 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $245.47 Median $338.84 Typical High $478.63 | Facility | None | $245.47 | $338.84 | $478.63 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $95.50 | Professional | None | $46.77 | $69.18 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $44.67 Typical High $100.00 | Facility | None | $38.02 | $44.67 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $102.33 | Professional | None | $52.48 | $79.43 | $102.33 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $1,174.90 | Facility | None | $66.07 | $107.15 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $338.84 Typical High $549.54 | Professional | None | $70.79 | $338.84 | $549.54 |
United Setting Facility Modifier None Typical Low $89.13 Median $575.44 Typical High $1,380.38 | Facility | None | $89.13 | $575.44 | $1,380.38 |
United Setting Professional Modifier None Typical Low $43.65 Median $67.61 Typical High $102.33 | Professional | None | $43.65 | $67.61 | $102.33 |
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 $23.44 Median $23.44 Typical High $38.02 | Professional | 52 · Reduced service | $23.44 | $23.44 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $15.14 | Professional | 53 · Discontinued | $9.33 | $9.33 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $35.48 Typical High $57.54 | Professional | 54 · Surgery only | $34.67 | $35.48 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $11.48 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $7.59 |
Where Oklahoma sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 21st of 51
$87.10
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.