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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $28.84 | Professional | None | $27.54 | $27.54 | $28.84 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $37.15 Typical High $331.13 | Facility | None | $31.62 | $37.15 | $331.13 |
Medica Setting Professional Modifier None Typical Low $25.12 Median $43.65 Typical High $524.81 | Professional | None | $25.12 | $43.65 | $524.81 |
United Setting Facility Modifier None Typical Low $40.74 Median $69.18 Typical High $69.18 | Facility | None | $40.74 | $69.18 | $69.18 |
United Setting Professional Modifier None Typical Low $19.95 Median $28.84 Typical High $43.65 | Professional | None | $19.95 | $28.84 | $43.65 |
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 $13.80 Median $13.80 Typical High $14.45 | Professional | 52 · Reduced service | $13.80 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | 53 · Discontinued | $5.50 | $5.50 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $4.27 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $2.88 |
Where Oklahoma sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 38th of 51
$36.31
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.