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 $70.79 Median $70.79 Typical High $93.33 | Facility | None | $70.79 | $70.79 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $93.33 | Professional | None | $70.79 | $93.33 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $134.90 | Professional | None | $70.79 | $112.20 | $134.90 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $151.36 | Professional | None | $83.18 | $109.65 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $114.82 | Professional | None | $72.44 | $95.50 | $114.82 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $109.65 Typical High $144.54 | Facility | None | $77.62 | $109.65 | $144.54 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $524.81 Typical High $724.44 | Professional | None | $95.50 | $524.81 | $724.44 |
United Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $125.89 | Professional | None | $70.79 | $93.33 | $125.89 |
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 $35.48 Median $43.65 Typical High $46.77 | Professional | 52 · Reduced service | $35.48 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.88 Typical High $14.13 | Professional | 55 · Aftercare only | $10.72 | $12.88 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.71 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.08 | $8.71 | $9.33 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $112.20 Typical High $141.25 | Professional | 25 · Same-day visit | $95.50 | $112.20 | $141.25 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | GE · Resident, primary care exception | $141.25 | $141.25 | $141.25 |
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
$110
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.