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 $72.44 Median $72.44 Typical High $95.50 | Facility | None | $72.44 | $72.44 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $95.50 | Professional | None | $72.44 | $95.50 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $144.54 | Professional | None | $93.33 | $102.33 | $144.54 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $154.88 | Professional | None | $87.10 | $112.20 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $117.49 | Professional | None | $75.86 | $95.50 | $117.49 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $112.20 Typical High $147.91 | Facility | None | $79.43 | $112.20 | $147.91 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $537.03 Typical High $724.44 | Professional | None | $97.72 | $537.03 | $724.44 |
United Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $128.82 | Professional | None | $74.13 | $97.72 | $128.82 |
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 $36.31 Median $44.67 Typical High $47.86 | Professional | 52 · Reduced service | $36.31 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.49 Typical High $14.45 | Professional | 55 · Aftercare only | $10.96 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.91 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.24 | $8.91 | $9.55 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $109.65 Typical High $114.82 | Professional | 25 · Same-day visit | $97.72 | $109.65 | $114.82 |
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· 26th 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.