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 $79.43 Median $3,890.45 Typical High $18,620.87 | Facility | None | $79.43 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $46.77 Typical High $79.43 | Professional | None | $21.38 | $46.77 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $21.38 Median $63.10 Typical High $104.71 | Professional | None | $21.38 | $63.10 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Medica Setting Facility Modifier None Typical Low $21.88 Median $66.07 Typical High $95.50 | Facility | None | $21.88 | $66.07 | $95.50 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $302.00 Typical High $537.03 | Professional | None | $54.95 | $302.00 | $537.03 |
United Setting Facility Modifier None Typical Low $89.13 Median $323.59 Typical High $524.81 | Facility | None | $89.13 | $323.59 | $524.81 |
United Setting Professional Modifier None Typical Low $18.62 Median $40.74 Typical High $81.28 | Professional | None | $18.62 | $40.74 | $81.28 |
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 $10.72 Median $20.89 Typical High $38.90 | Professional | 52 · Reduced service | $10.72 | $20.89 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $8.51 Typical High $15.85 | Professional | 53 · Discontinued | $4.27 | $8.51 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $6.31 Typical High $11.75 | Professional | 55 · Aftercare only | $3.24 | $6.31 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $4.27 Typical High $7.94 | Professional | 56 · Pre-op care only | $2.14 | $4.27 | $7.94 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 59 · Distinct service | $74.13 | $74.13 | $74.13 |
Where Oklahoma sits
The same service costs 6.5 times more in Alaska than in Indiana. 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· 11th of 51
$74.13
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.