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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | None | $125.89 | $131.83 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $177.83 Typical High $302.00 | Professional | None | $64.57 | $177.83 | $302.00 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | None | $141.25 | $141.25 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $275.42 Typical High $1,288.25 | Facility | None | $131.83 | $275.42 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $1,380.38 | Professional | None | $102.33 | $190.55 | $1,380.38 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $190.55 | Professional | None | $81.28 | $123.03 | $190.55 |
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 $63.10 Median $63.10 Typical High $64.57 | Professional | 52 · Reduced service | $63.10 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $26.30 | Professional | 53 · Discontinued | $25.12 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $13.18 |
Where Oklahoma sits
The same service costs 2.2 times more in Hawaii 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· 28th of 51
$174
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.