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 $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier None Typical Low $0.85 Median $1.70 Typical High $1.70 | Professional | None | $0.85 | $1.70 | $1.70 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
Medica Setting Facility Modifier None Typical Low $1.74 Median $1.78 Typical High $79.43 | Facility | None | $1.74 | $1.78 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.02 Median $1.78 Typical High $14.45 | Professional | None | $1.02 | $1.78 | $14.45 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.23 Typical High $1.78 | Professional | None | $0.81 | $1.23 | $1.78 |
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 $0.85 Median $0.85 Typical High $0.85 | Professional | 52 · Reduced service | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 53 · Discontinued | $0.34 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $0.26 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.17 |
Where Oklahoma sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 41st of 51
$1.74
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.