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 $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Ambetter Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Medica Setting Facility Modifier None Typical Low $5.37 Median $6.03 Typical High $14.45 | Facility | None | $5.37 | $6.03 | $14.45 |
Medica Setting Professional Modifier None Typical Low $4.68 Median $8.13 Typical High $69.18 | Professional | None | $4.68 | $8.13 | $69.18 |
United Setting Professional Modifier None Typical Low $3.72 Median $4.68 Typical High $10.23 | Professional | None | $3.72 | $4.68 | $10.23 |
3 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 55 · Aftercare only Typical Low $0.79 Median $0.81 Typical High $0.81 | Professional | 55 · Aftercare only | $0.79 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.54 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.52 | $0.54 | $0.54 |
Ambetter Setting Professional Modifier GY · Excluded by law Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | GY · Excluded by law | $7.76 | $7.76 | $7.76 |
Where Oklahoma sits
The same service costs 3.2 times more in Minnesota 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· 45th of 51
$6.03
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.