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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | None | $165.96 | $165.96 | $173.78 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $1,445.44 | Facility | None | $190.55 | $223.87 | $1,445.44 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $2,344.23 | Professional | None | $114.82 | $194.98 | $2,344.23 |
United Setting Facility Modifier None Typical Low $181.97 Median $316.23 Typical High $316.23 | Facility | None | $181.97 | $316.23 | $316.23 |
United Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $194.98 | Professional | None | $91.20 | $138.04 | $194.98 |
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 $83.18 Median $83.18 Typical High $87.10 | Professional | 52 · Reduced service | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $34.67 | Professional | 53 · Discontinued | $33.11 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $25.70 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $17.38 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $17.38 |
Where Oklahoma sits
The same service costs 4.7 times more in Hawaii 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· 21st of 51
$191
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.