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 $104.71 Median $2,454.71 Typical High $7,585.78 | Facility | None | $104.71 | $2,454.71 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $138.04 | Professional | None | $64.57 | $104.71 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $128.82 | Professional | None | $81.28 | $95.50 | $128.82 |
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 $77.62 Median $107.15 Typical High $134.90 | Professional | None | $77.62 | $107.15 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $100.00 | Facility | None | $50.12 | $60.26 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $151.36 | Professional | None | $75.86 | $117.49 | $151.36 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $151.36 Typical High $1,174.90 | Facility | None | $85.11 | $151.36 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $467.74 Typical High $758.58 | Professional | None | $100.00 | $467.74 | $758.58 |
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 $67.61 Median $100.00 Typical High $144.54 | Professional | None | $67.61 | $100.00 | $144.54 |
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 $32.36 Median $33.11 Typical High $52.48 | Professional | 52 · Reduced service | $32.36 | $33.11 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $20.89 | Professional | 53 · Discontinued | $13.18 | $13.18 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $79.43 | Professional | 54 · Surgery only | $48.98 | $48.98 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.00 Typical High $15.85 | Professional | 55 · Aftercare only | $9.77 | $10.00 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.61 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.46 | $6.61 | $10.47 |
Where Oklahoma sits
The same service costs 3.0 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· 21st of 51
$123
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.