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 $6.03 Median $6.03 Typical High $6.46 | Facility | None | $6.03 | $6.03 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $6.03 Typical High $6.03 | Professional | None | $5.89 | $6.03 | $6.03 |
Ambetter Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $9.77 | Professional | None | $7.08 | $7.08 | $9.77 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Medica Setting Facility Modifier None Typical Low $6.46 Median $9.12 Typical High $89.13 | Facility | None | $6.46 | $9.12 | $89.13 |
Medica Setting Professional Modifier None Typical Low $6.61 Median $11.48 Typical High $87.10 | Professional | None | $6.61 | $11.48 | $87.10 |
United Setting Professional Modifier None Typical Low $5.37 Median $7.08 Typical High $14.79 | Professional | None | $5.37 | $7.08 | $14.79 |
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 $2.95 Median $2.95 Typical High $3.02 | Professional | 52 · Reduced service | $2.95 | $2.95 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.17 Typical High $1.23 | Professional | 53 · Discontinued | $1.17 | $1.17 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $0.91 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.59 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.59 | $0.59 | $0.62 |
Where Oklahoma sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 39th of 51
$12.02
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.