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 $97.72 Median $97.72 Typical High $123.03 | Facility | None | $97.72 | $97.72 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | None | $97.72 | $123.03 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $181.97 | Professional | None | $125.89 | $138.04 | $181.97 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $199.53 | Professional | None | $114.82 | $144.54 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $151.36 | Professional | None | $95.50 | $128.82 | $151.36 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $190.55 | Facility | None | $104.71 | $147.91 | $190.55 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $724.44 Typical High $954.99 | Professional | None | $125.89 | $724.44 | $954.99 |
United Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $165.96 | Professional | None | $97.72 | $125.89 | $165.96 |
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 $48.98 Median $57.54 Typical High $61.66 | Professional | 52 · Reduced service | $48.98 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $17.38 Typical High $18.62 | Professional | 55 · Aftercare only | $14.79 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.48 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.77 | $11.48 | $12.30 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 25 · Same-day visit | $125.89 | $125.89 | $147.91 |
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· 27th of 51
$141
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.