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 $63.10 Median $91.20 Typical High $91.20 | Facility | None | $63.10 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $63.10 | Professional | None | $58.88 | $63.10 | $63.10 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $63.10 Median $102.33 Typical High $162.18 | Facility | None | $63.10 | $102.33 | $162.18 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $154.88 Typical High $165.96 | Facility | None | $87.10 | $154.88 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $70.79 Typical High $371.54 | Facility | None | $63.10 | $70.79 | $371.54 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $302.00 | Professional | None | $63.10 | $66.07 | $302.00 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $66.07 | Professional | None | $51.29 | $60.26 | $66.07 |
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 $29.51 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $29.51 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $11.75 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.89 | $6.31 | $6.31 |
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· 18th of 51
$63.10
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.