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 $426.58 Median $588.84 Typical High $588.84 | Facility | None | $426.58 | $588.84 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $446.68 | Professional | None | $416.87 | $446.68 | $446.68 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $323.59 | Facility | None | $125.89 | $204.17 | $323.59 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $457.09 | Facility | None | $316.23 | $316.23 | $457.09 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $1,584.89 | Professional | None | $338.84 | $407.38 | $1,584.89 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $436.52 | Professional | None | $331.13 | $389.05 | $436.52 |
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 $208.93 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $208.93 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $83.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $44.67 |
Where Oklahoma sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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· 51st of 51
$389
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.