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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $194.98 | Professional | None | $186.21 | $186.21 | $194.98 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $251.19 Typical High $2,089.30 | Facility | None | $213.80 | $251.19 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $2,511.89 | Professional | None | $162.18 | $281.84 | $2,511.89 |
United Setting Facility Modifier None Typical Low $147.91 Median $457.09 Typical High $457.09 | Facility | None | $147.91 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $281.84 | Professional | None | $131.83 | $194.98 | $281.84 |
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 $93.33 Median $93.33 Typical High $95.50 | Professional | 52 · Reduced service | $93.33 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | 53 · Discontinued | $37.15 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $28.84 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $19.50 |
Where Oklahoma sits
The same service costs 2.9 times more in Montana than in Delaware. 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· 42nd of 51
$219
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.