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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | None | $79.43 | $79.43 | $81.28 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $107.15 Typical High $812.83 | Facility | None | $91.20 | $107.15 | $812.83 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $870.96 | Professional | None | $64.57 | $109.65 | $870.96 |
United Setting Facility Modifier None Typical Low $57.54 Median $177.83 Typical High $177.83 | Facility | None | $57.54 | $177.83 | $177.83 |
United Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $109.65 | Professional | None | $51.29 | $77.62 | $109.65 |
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 $39.81 Median $39.81 Typical High $40.74 | Professional | 52 · Reduced service | $39.81 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $16.60 | Professional | 53 · Discontinued | $15.85 | $15.85 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $8.13 |
Where Oklahoma sits
The same service costs 2.1 times more in Montana than in Florida. 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· 25th of 51
$105
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.