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 $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.90 Typical High $4.90 | Professional | None | $4.79 | $4.90 | $4.90 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Medica Setting Facility Modifier None Typical Low $5.01 Median $5.13 Typical High $11.22 | Facility | None | $5.01 | $5.13 | $11.22 |
Medica Setting Professional Modifier None Typical Low $2.95 Median $5.01 Typical High $40.74 | Professional | None | $2.95 | $5.01 | $40.74 |
United Setting Professional Modifier None Typical Low $2.34 Median $2.95 Typical High $5.01 | Professional | None | $2.34 | $2.95 | $5.01 |
6 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 $2.40 Median $2.45 Typical High $2.45 | Professional | 52 · Reduced service | $2.40 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $0.98 Typical High $0.98 | Professional | 53 · Discontinued | $0.98 | $0.98 | $0.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.74 Typical High $0.74 | Professional | 55 · Aftercare only | $0.72 | $0.74 | $0.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.49 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.48 | $0.49 | $0.49 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | A1 · Dressing, 1 wound | $8.32 | $8.32 | $8.32 |
Ambetter Setting Professional Modifier A2 · Dressing, 2 wounds Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | A2 · Dressing, 2 wounds | $6.31 | $6.31 | $6.31 |
Where Oklahoma sits
The same service costs 2.6 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· 34th of 51
$4.27
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.