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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.70 Typical High $25.70 | Professional | None | $25.12 | $25.70 | $25.70 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $26.92 Typical High $58.88 | Facility | None | $25.70 | $26.92 | $58.88 |
Medica Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $213.80 | Professional | None | $15.14 | $15.14 | $213.80 |
United Setting Professional Modifier None Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | None | $13.49 | $15.14 | $15.14 |
5 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 $12.59 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.59 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.80 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.51 | $2.57 | $2.57 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $33.11 Median $33.11 Typical High $43.65 | Professional | A1 · Dressing, 1 wound | $33.11 | $33.11 | $43.65 |
Where Oklahoma sits
The same service costs 3.2 times more in Hawaii than in Utah. 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· 30th of 51
$21.88
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.