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 $17.38 Median $17.38 Typical High $57.54 | Facility | None | $17.38 | $17.38 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $48.98 Typical High $58.88 | Professional | None | $17.38 | $48.98 | $58.88 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $173.78 | Facility | None | $162.18 | $162.18 | $173.78 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $18.20 Median $50.12 Typical High $83.18 | Professional | None | $18.20 | $50.12 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $47.86 Typical High $109.65 | Professional | None | $24.55 | $47.86 | $109.65 |
Medica Setting Facility Modifier None Typical Low $17.78 Median $57.54 Typical High $81.28 | Facility | None | $17.78 | $57.54 | $81.28 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $114.82 Typical High $407.38 | Professional | None | $58.88 | $114.82 | $407.38 |
United Setting Facility Modifier None Typical Low $25.70 Median $95.50 Typical High $151.36 | Facility | None | $25.70 | $95.50 | $151.36 |
United Setting Professional Modifier None Typical Low $15.85 Median $44.67 Typical High $72.44 | Professional | None | $15.85 | $44.67 | $72.44 |
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 $8.71 Median $24.55 Typical High $29.51 | Professional | 52 · Reduced service | $8.71 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $9.77 Typical High $11.75 | Professional | 53 · Discontinued | $3.47 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $7.41 Typical High $8.71 | Professional | 55 · Aftercare only | $2.57 | $7.41 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $4.90 Typical High $5.89 | Professional | 56 · Pre-op care only | $1.74 | $4.90 | $5.89 |
Where Oklahoma sits
The same service costs 4.9 times more in Hawaii 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· 20th of 51
$60.26
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.