How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $30.90 Median $43.65 Typical High $43.65 | Facility | None | $30.90 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $30.90 | Professional | None | $28.84 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Medica Setting Facility Modifier None Typical Low $28.84 Median $32.36 Typical High $144.54 | Facility | None | $28.84 | $32.36 | $144.54 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $32.36 Typical High $144.54 | Professional | None | $26.92 | $32.36 | $144.54 |
United Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $23.99 Median $28.84 Typical High $31.62 | Professional | None | $23.99 | $28.84 | $31.62 |
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 $14.45 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $14.45 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $5.75 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.37 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.88 | $3.09 | $3.09 |
Where Oklahoma sits
Rates are fairly even across states for this service. 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· 13th of 51
$32.36
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.