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 $28.84 Median $43.65 Typical High $56.23 | Facility | None | $28.84 | $43.65 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $43.65 Typical High $51.29 | Professional | None | $28.84 | $43.65 | $51.29 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $54.95 Typical High $72.44 | Professional | None | $30.20 | $54.95 | $72.44 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $72.44 | Professional | None | $34.67 | $47.86 | $72.44 |
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 $33.88 Median $36.31 Typical High $56.23 | Professional | None | $33.88 | $36.31 | $56.23 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $51.29 Typical High $74.13 | Facility | None | $30.20 | $51.29 | $74.13 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $223.87 Typical High $354.81 | Professional | None | $37.15 | $223.87 | $354.81 |
United Setting Professional Modifier None Typical Low $20.89 Median $37.15 Typical High $48.98 | Professional | None | $20.89 | $37.15 | $48.98 |
8 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 $14.45 Median $17.78 Typical High $21.88 | Professional | 52 · Reduced service | $14.45 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.37 Typical High $6.61 | Professional | 55 · Aftercare only | $4.27 | $5.37 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.55 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.88 | $3.55 | $4.47 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $31.62 Median $31.62 Typical High $54.95 | Professional | 24 · Unrelated visit after surgery | $31.62 | $31.62 | $54.95 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $30.20 Median $52.48 Typical High $57.54 | Professional | 25 · Same-day visit | $30.20 | $52.48 | $57.54 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $46.77 Median $54.95 Typical High $54.95 | Professional | 93 · Audio-only telehealth | $46.77 | $54.95 | $54.95 |
Ambetter Setting Professional Modifier CG · Policy criteria applied Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | CG · Policy criteria applied | $54.95 | $54.95 | $54.95 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | GC · Resident with teaching physician | $69.18 | $69.18 | $69.18 |
Where Oklahoma sits
The same service costs 2.4 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
$44.67
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.