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 $2.95 Median $2.95 Typical High $2.95 | Facility | None | $2.95 | $2.95 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.95 Typical High $2.95 | Professional | None | $2.57 | $2.95 | $2.95 |
Ambetter Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $2.14 Median $3.02 Typical High $3.31 | Facility | None | $2.14 | $3.02 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Medica Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $79.43 | Facility | None | $3.09 | $3.09 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.78 Median $3.02 Typical High $25.12 | Professional | None | $1.78 | $3.02 | $25.12 |
United Setting Professional Modifier None Typical Low $1.41 Median $2.09 Typical High $3.02 | Professional | None | $1.41 | $2.09 | $3.02 |
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 $1.48 Median $1.48 Typical High $1.48 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.60 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.45 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.30 |
Where Oklahoma sits
The same service costs 2.3 times more in Kansas than in Connecticut. 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
$3.02
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.