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 $81.28 Median $81.28 Typical High $107.15 | Facility | None | $81.28 | $81.28 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $107.15 | Professional | None | $81.28 | $107.15 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $158.49 | Professional | None | $107.15 | $125.89 | $158.49 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $169.82 | Professional | None | $93.33 | $125.89 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $131.83 | Professional | None | $83.18 | $107.15 | $131.83 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $123.03 Typical High $162.18 | Facility | None | $87.10 | $123.03 | $162.18 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $602.56 Typical High $812.83 | Professional | None | $107.15 | $602.56 | $812.83 |
United Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $141.25 | Professional | None | $81.28 | $107.15 | $141.25 |
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 $39.81 Median $48.98 Typical High $53.70 | Professional | 52 · Reduced service | $39.81 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.79 Typical High $16.22 | Professional | 55 · Aftercare only | $12.02 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.77 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.13 | $9.77 | $10.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $107.15 Median $125.89 Typical High $158.49 | Professional | 25 · Same-day visit | $107.15 | $125.89 | $158.49 |
Where Oklahoma sits
The same service costs 2.7 times more in Alaska than in Washington, DC. 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· 24th of 51
$126
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.