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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $512.86 | Professional | None | $489.78 | $489.78 | $512.86 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $1,202.26 Typical High $3,890.45 | Facility | None | $436.52 | $1,202.26 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $954.99 Typical High $6,456.54 | Professional | None | $524.81 | $954.99 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $1,000.00 | Professional | None | $416.87 | $630.96 | $1,000.00 |
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 $245.47 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $97.72 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $51.29 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | KX · Policy requirements met | $776.25 | $776.25 | $776.25 |
Where Oklahoma sits
The same service costs 2.8 times more in Hawaii than in Utah. 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
$832
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.