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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | None | $34.67 | $34.67 | $36.31 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $46.77 Typical High $398.11 | Facility | None | $39.81 | $46.77 | $398.11 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $54.95 Typical High $501.19 | Professional | None | $31.62 | $54.95 | $501.19 |
United Setting Facility Modifier None Typical Low $47.86 Median $89.13 Typical High $89.13 | Facility | None | $47.86 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $25.12 Median $36.31 Typical High $54.95 | Professional | None | $25.12 | $36.31 | $54.95 |
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 $17.38 Median $17.38 Typical High $18.20 | Professional | 52 · Reduced service | $17.38 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $7.24 | Professional | 53 · Discontinued | $6.92 | $6.92 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $5.37 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $3.63 |
Where Oklahoma sits
The same service costs 3.1 times more in Hawaii than in West Virginia. 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· 32nd of 51
$46.77
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.