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 $79.43 Median $97.72 Typical High $141.25 | Facility | None | $79.43 | $97.72 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $141.25 | Professional | None | $79.43 | $114.82 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $89.13 | Professional | None | $60.26 | $70.79 | $89.13 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $131.83 | Professional | None | $95.50 | $104.71 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $154.88 | Professional | None | $83.18 | $83.18 | $154.88 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $154.88 | Facility | None | $125.89 | $125.89 | $154.88 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $616.60 | Professional | None | $83.18 | $117.49 | $616.60 |
United Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $138.04 | Professional | None | $83.18 | $104.71 | $138.04 |
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 $38.90 Median $38.90 Typical High $40.74 | Professional | 52 · Reduced service | $38.90 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $8.32 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $64.57 Median $70.79 Typical High $85.11 | Professional | 25 · Same-day visit | $64.57 | $70.79 | $85.11 |
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· 27th 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.