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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | None | $281.84 | $316.23 | $316.23 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $2,511.89 | Facility | None | $338.84 | $407.38 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $3,235.94 | Professional | None | $204.17 | $371.54 | $3,235.94 |
United Setting Facility Modifier None Typical Low $138.04 Median $562.34 Typical High $562.34 | Facility | None | $138.04 | $562.34 | $562.34 |
United Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $363.08 | Professional | None | $162.18 | $245.47 | $363.08 |
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 $141.25 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $141.25 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $41.69 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.18 | $31.62 | $31.62 |
Where Oklahoma sits
The same service costs 2.7 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· 27th of 51
$316
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.