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 $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.89 | Professional | None | $3.80 | $3.80 | $3.89 |
Ambetter Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $4.79 | Facility | None | $3.89 | $3.89 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Medica Setting Facility Modifier None Typical Low $3.98 Median $4.07 Typical High $79.43 | Facility | None | $3.98 | $4.07 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.29 Median $4.27 Typical High $32.36 | Professional | None | $2.29 | $4.27 | $32.36 |
United Setting Professional Modifier None Typical Low $1.86 Median $2.75 Typical High $4.27 | Professional | None | $1.86 | $2.75 | $4.27 |
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 $1.91 Median $1.91 Typical High $1.95 | Professional | 52 · Reduced service | $1.91 | $1.91 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 53 · Discontinued | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $0.58 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.38 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.38 | $0.38 | $0.39 |
Where Oklahoma sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 35th of 51
$3.89
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.