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 $35.48 Median $35.48 Typical High $36.31 | Professional | None | $35.48 | $35.48 | $36.31 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
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 $40.74 Median $47.86 Typical High $416.87 | Facility | None | $40.74 | $47.86 | $416.87 |
Medica Setting Professional Modifier None Typical Low $31.62 Median $54.95 Typical High $562.34 | Professional | None | $31.62 | $54.95 | $562.34 |
United Setting Facility Modifier None Typical Low $51.29 Median $87.10 Typical High $87.10 | Facility | None | $51.29 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $25.12 Median $37.15 Typical High $54.95 | Professional | None | $25.12 | $37.15 | $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 $17.78 Median $17.78 Typical High $18.20 | Professional | 52 · Reduced service | $17.78 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $7.41 | Professional | 53 · Discontinued | $7.08 | $7.08 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $5.50 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $3.63 |
Where Oklahoma sits
The same service costs 3.5 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· 34th 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.