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 $56.23 Median $67.61 Typical High $89.13 | Facility | None | $56.23 | $67.61 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $89.13 | Professional | None | $56.23 | $75.86 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $83.18 | Professional | None | $54.95 | $64.57 | $83.18 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $95.50 | Professional | None | $69.18 | $74.13 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $112.20 | Professional | None | $77.62 | $81.28 | $112.20 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Facility | None | $89.13 | $89.13 | $107.15 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $478.63 | Professional | None | $67.61 | $95.50 | $478.63 |
United Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $102.33 | Professional | None | $61.66 | $74.13 | $102.33 |
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 $28.18 Median $28.18 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $10.23 | Professional | 55 · Aftercare only | $8.32 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.92 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $72.44 Median $75.86 Typical High $93.33 | Professional | 25 · Same-day visit | $72.44 | $75.86 | $93.33 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | GC · Resident with teaching physician | $89.13 | $89.13 | $100.00 |
Where Oklahoma sits
The same service costs 2.3 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· 41st of 51
$75.86
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.