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 $66.07 Median $102.33 Typical High $151.36 | Facility | None | $66.07 | $102.33 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $123.03 | Professional | None | $66.07 | $91.20 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $138.04 | Professional | None | $69.18 | $104.71 | $138.04 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $147.91 | Professional | None | $81.28 | $107.15 | $147.91 |
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 $72.44 Median $89.13 Typical High $112.20 | Professional | None | $72.44 | $89.13 | $112.20 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $114.82 Typical High $147.91 | Facility | None | $72.44 | $114.82 | $147.91 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $512.86 Typical High $691.83 | Professional | None | $91.20 | $512.86 | $691.83 |
United Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $114.82 | Professional | None | $61.66 | $87.10 | $114.82 |
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 $33.11 Median $41.69 Typical High $43.65 | Professional | 52 · Reduced service | $33.11 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.59 Typical High $13.18 | Professional | 55 · Aftercare only | $10.00 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.61 | $8.32 | $8.91 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $89.13 Median $109.65 Typical High $138.04 | Professional | 25 · Same-day visit | $89.13 | $109.65 | $138.04 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | GC · Resident with teaching physician | $138.04 | $138.04 | $138.04 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $112.20 Typical High $131.83 | Professional | 25 · Same-day visit | $95.50 | $112.20 | $131.83 |
Where Oklahoma sits
The same service costs 2.3 times more in Alaska than in Alabama. 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
$105
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.