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 $91.20 Median $3,890.45 Typical High $18,620.87 | Facility | None | $91.20 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $93.33 | Professional | None | $58.88 | $85.11 | $93.33 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $54.95 Median $85.11 Typical High $117.49 | Professional | None | $54.95 | $85.11 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $63.10 Typical High $467.74 | Facility | None | $52.48 | $63.10 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $123.03 | Professional | None | $64.57 | $95.50 | $123.03 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $120.23 Typical High $1,174.90 | Facility | None | $75.86 | $120.23 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $426.58 Typical High $676.08 | Professional | None | $87.10 | $426.58 | $676.08 |
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 $54.95 Median $83.18 Typical High $128.82 | Professional | None | $54.95 | $83.18 | $128.82 |
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 $29.51 Median $30.20 Typical High $46.77 | Professional | 52 · Reduced service | $29.51 | $30.20 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.02 Typical High $18.62 | Professional | 53 · Discontinued | $11.75 | $12.02 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $69.18 | Professional | 54 · Surgery only | $44.67 | $44.67 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $13.80 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.03 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.89 | $6.03 | $9.33 |
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· 22nd of 51
$107
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.