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 $1.55 Median $1.55 Typical High $1.55 | Facility | None | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $1.55 Typical High $1.55 | Professional | None | $1.51 | $1.55 | $1.55 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Medica Setting Facility Modifier None Typical Low $1.58 Median $1.62 Typical High $3.55 | Facility | None | $1.58 | $1.62 | $3.55 |
Medica Setting Professional Modifier None Typical Low $0.93 Median $1.58 Typical High $12.88 | Professional | None | $0.93 | $1.58 | $12.88 |
United Setting Professional Modifier None Typical Low $0.74 Median $0.93 Typical High $1.58 | Professional | None | $0.74 | $0.93 | $1.58 |
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 $0.78 Median $0.78 Typical High $0.78 | Professional | 52 · Reduced service | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 53 · Discontinued | $0.31 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.15 | $0.16 | $0.16 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | A1 · Dressing, 1 wound | $2.00 | $2.00 | $2.00 |
Where Oklahoma sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 49th of 51
$1.32
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.