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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $112.20 | Professional | None | $107.15 | $107.15 | $112.20 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $144.54 Typical High $912.01 | Facility | None | $123.03 | $144.54 | $912.01 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $1,174.90 | Professional | None | $74.13 | $125.89 | $1,174.90 |
United Setting Facility Modifier None Typical Low $89.13 Median $204.17 Typical High $204.17 | Facility | None | $89.13 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $125.89 | Professional | None | $58.88 | $87.10 | $125.89 |
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 $53.70 Median $53.70 Typical High $54.95 | Professional | 52 · Reduced service | $53.70 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 53 · Discontinued | $21.38 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.60 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $11.22 |
Where Oklahoma sits
The same service costs 3.0 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· 22nd of 51
$112
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.