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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | None | $199.53 | $199.53 | $204.17 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $2,089.30 | Facility | None | $223.87 | $269.15 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $3,890.45 | Professional | None | $158.49 | $269.15 | $3,890.45 |
United Setting Facility Modifier None Typical Low $251.19 Median $436.52 Typical High $436.52 | Facility | None | $251.19 | $436.52 | $436.52 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $269.15 | Professional | None | $125.89 | $190.55 | $269.15 |
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 $97.72 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $97.72 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $40.74 | Professional | 53 · Discontinued | $39.81 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $20.42 |
Where Oklahoma sits
The same service costs 5.5 times more in Hawaii 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· 43rd of 51
$214
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.