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 $7.24 Median $10.23 Typical High $12.30 | Facility | None | $7.24 | $10.23 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $10.23 Typical High $10.23 | Professional | None | $9.55 | $10.23 | $10.23 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $6.31 Median $10.23 Typical High $16.22 | Facility | None | $6.31 | $10.23 | $16.22 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $25.12 Typical High $26.92 | Facility | None | $14.45 | $25.12 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Medica Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $12.02 | Facility | None | $4.79 | $4.79 | $12.02 |
Medica Setting Professional Modifier None Typical Low $6.92 Median $7.94 Typical High $8.71 | Professional | None | $6.92 | $7.94 | $8.71 |
United Setting Professional Modifier None Typical Low $6.92 Median $8.13 Typical High $9.12 | Professional | None | $6.92 | $8.13 | $9.12 |
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 $4.79 Median $5.13 Typical High $5.13 | Professional | 52 · Reduced service | $4.79 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $2.04 Typical High $2.04 | Professional | 53 · Discontinued | $1.91 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.55 Typical High $1.55 | Professional | 55 · Aftercare only | $1.45 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.02 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.95 | $1.02 | $1.02 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | JZ · No drug discarded | $8.13 | $8.13 | $8.13 |
Where Oklahoma sits
The same service costs 1.7 times more in Wyoming than in North Carolina. 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· 50th of 51
$8.51
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.