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 $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $5.62 Typical High $5.75 | Professional | None | $2.82 | $5.62 | $5.75 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $5.75 Typical High $7.24 | Facility | None | $3.63 | $5.75 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Medica Setting Facility Modifier None Typical Low $5.75 Median $6.03 Typical High $79.43 | Facility | None | $5.75 | $6.03 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.39 Median $5.89 Typical High $61.66 | Professional | None | $3.39 | $5.89 | $61.66 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.07 Typical High $5.89 | Professional | None | $2.75 | $4.07 | $5.89 |
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 $2.82 Median $2.82 Typical High $2.88 | Professional | 52 · Reduced service | $2.82 | $2.82 | $2.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.15 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 55 · Aftercare only | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.58 |
Where Oklahoma sits
The same service costs 2.5 times more in Montana than in New Hampshire. 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
$5.89
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.