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 $38.90 Median $57.54 Typical High $85.11 | Facility | None | $38.90 | $57.54 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $63.10 Typical High $85.11 | Professional | None | $38.90 | $63.10 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $97.72 | Professional | None | $60.26 | $70.79 | $97.72 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $95.50 | Professional | None | $47.86 | $66.07 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $125.89 Typical High $134.90 | Facility | None | $109.65 | $125.89 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $74.13 | Professional | None | $45.71 | $60.26 | $74.13 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $77.62 Typical High $102.33 | Facility | None | $42.66 | $77.62 | $102.33 |
Medica Setting Professional Modifier None Typical Low $61.66 Median $302.00 Typical High $457.09 | Professional | None | $61.66 | $302.00 | $457.09 |
United Setting Professional Modifier None Typical Low $41.69 Median $61.66 Typical High $79.43 | Professional | None | $41.69 | $61.66 | $79.43 |
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 $19.50 Median $26.92 Typical High $28.84 | Professional | 52 · Reduced service | $19.50 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.13 Typical High $8.51 | Professional | 55 · Aftercare only | $5.75 | $8.13 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.37 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.89 | $5.37 | $5.75 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $70.79 Median $70.79 Typical High $87.10 | Professional | 25 · Same-day visit | $70.79 | $70.79 | $87.10 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | GC · Resident with teaching physician | $87.10 | $87.10 | $87.10 |
Where Oklahoma sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 23rd of 51
$67.61
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.