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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | None | $20.89 | $20.89 | $21.88 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Medica Setting Facility Modifier None Typical Low $22.91 Median $28.84 Typical High $213.80 | Facility | None | $22.91 | $28.84 | $213.80 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $29.51 Typical High $229.09 | Professional | None | $16.98 | $29.51 | $229.09 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
United Setting Professional Modifier None Typical Low $13.80 Median $20.42 Typical High $29.51 | Professional | None | $13.80 | $20.42 | $29.51 |
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 $10.47 Median $10.47 Typical High $10.96 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.37 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.31 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.19 |
Where Oklahoma sits
The same service costs 2.5 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· 46th of 51
$22.39
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.