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 $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $281.84 | Professional | None | $275.42 | $275.42 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $371.54 | Professional | None | $269.15 | $275.42 | $371.54 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $398.11 | Professional | None | $288.40 | $363.08 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $338.84 | Professional | None | $263.03 | $338.84 | $338.84 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $389.05 | Facility | None | $223.87 | $223.87 | $389.05 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $1,905.46 | Professional | None | $218.78 | $295.12 | $1,905.46 |
United Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $371.54 | Professional | None | $194.98 | $245.47 | $371.54 |
4 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 $134.90 Median $141.25 Typical High $144.54 | Professional | 52 · Reduced service | $134.90 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $56.23 Typical High $57.54 | Professional | 53 · Discontinued | $53.70 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $41.69 Typical High $43.65 | Professional | 55 · Aftercare only | $40.74 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.18 Typical High $28.84 | Professional | 56 · Pre-op care only | $26.92 | $28.18 | $28.84 |
Where Oklahoma sits
The same service costs 2.8 times more in Alaska than in New York. 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· 26th of 51
$316
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.