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 $173.78 Median $3,890.45 Typical High $18,620.87 | Facility | None | $173.78 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $162.18 Typical High $177.83 | Professional | None | $61.66 | $162.18 | $177.83 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $707.95 | Facility | None | $363.08 | $501.19 | $707.95 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $81.28 Median $229.09 Typical High $251.19 | Professional | None | $81.28 | $229.09 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $63.10 | Facility | None | $61.66 | $61.66 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $154.88 Typical High $245.47 | Professional | None | $74.13 | $154.88 | $245.47 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $112.20 Typical High $234.42 | Facility | None | $63.10 | $112.20 | $234.42 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $741.31 Typical High $1,230.27 | Professional | None | $173.78 | $741.31 | $1,230.27 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $58.88 | Facility | None | $43.65 | $43.65 | $58.88 |
United Setting Professional Modifier None Typical Low $63.10 Median $147.91 Typical High $263.03 | Professional | None | $63.10 | $147.91 | $263.03 |
6 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 $30.90 Median $45.71 Typical High $91.20 | Professional | 52 · Reduced service | $30.90 | $45.71 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $18.20 Typical High $36.31 | Professional | 53 · Discontinued | $12.30 | $18.20 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $67.61 Typical High $134.90 | Professional | 54 · Surgery only | $46.77 | $67.61 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.49 Typical High $27.54 | Professional | 55 · Aftercare only | $9.33 | $13.49 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $9.12 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.17 | $9.12 | $18.20 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | GN · Speech therapy plan | $245.47 | $245.47 | $245.47 |
Where Oklahoma sits
The same service costs 2.9 times more in Washington 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· 11th of 51
$200
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.