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 $58.88 Median $3,890.45 Typical High $18,620.87 | Facility | None | $58.88 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $58.88 | Professional | None | $38.02 | $51.29 | $58.88 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $109.65 Median $154.88 Typical High $218.78 | Facility | None | $109.65 | $154.88 | $218.78 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $66.07 | Professional | None | $33.88 | $47.86 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $2,691.53 | Facility | None | $1,202.26 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $66.07 Typical High $1,122.02 | Facility | None | $30.20 | $66.07 | $1,122.02 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $204.17 Typical High $323.59 | Professional | None | $44.67 | $204.17 | $323.59 |
United Setting Facility Modifier None Typical Low $89.13 Median $616.60 Typical High $1,380.38 | Facility | None | $89.13 | $616.60 | $1,380.38 |
United Setting Professional Modifier None Typical Low $30.20 Median $47.86 Typical High $87.10 | Professional | None | $30.20 | $47.86 | $87.10 |
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 $19.05 Median $19.50 Typical High $29.51 | Professional | 52 · Reduced service | $19.05 | $19.50 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.76 Typical High $12.02 | Professional | 53 · Discontinued | $7.59 | $7.76 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $28.84 Typical High $44.67 | Professional | 54 · Surgery only | $28.18 | $28.84 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.75 Typical High $8.91 | Professional | 55 · Aftercare only | $5.62 | $5.75 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $3.80 | $3.89 | $5.89 |
Where Oklahoma sits
The same service costs 2.8 times more in Alaska than in California. 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· 16th of 51
$60.26
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.