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 $0.31 Median $0.31 Typical High $0.34 | Facility | None | $0.31 | $0.31 | $0.34 |
Aetna Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $0.31 | Professional | None | $0.30 | $0.30 | $0.31 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | RR · Rental | $0.02 | $0.02 | $0.03 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $0.46 Median $0.46 Typical High $0.46 | Facility | None | $0.46 | $0.46 | $0.46 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | None | $0.46 | $0.46 | $0.46 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Medica Setting Facility Modifier None Typical Low $0.32 Median $0.33 Typical High $6.61 | Facility | None | $0.32 | $0.33 | $6.61 |
Medica Setting Professional Modifier None Typical Low $0.22 Median $0.38 Typical High $4.27 | Professional | None | $0.22 | $0.38 | $4.27 |
United Setting Professional Modifier None Typical Low $0.17 Median $0.22 Typical High $0.38 | Professional | None | $0.17 | $0.22 | $0.38 |
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 $0.16 Median $0.16 Typical High $0.16 | Professional | 52 · Reduced service | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Where Oklahoma sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 36th of 51
$0.31
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.