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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $426.58 | Professional | None | $371.54 | $426.58 | $426.58 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $3,311.31 | Facility | None | $446.68 | $537.03 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $489.78 Typical High $4,365.16 | Professional | None | $269.15 | $489.78 | $4,365.16 |
United Setting Facility Modifier None Typical Low $165.96 Median $758.58 Typical High $758.58 | Facility | None | $165.96 | $758.58 | $758.58 |
United Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $489.78 | Professional | None | $218.78 | $323.59 | $489.78 |
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 $186.21 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $186.21 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $56.23 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $37.15 | $42.66 | $42.66 |
Where Oklahoma sits
The same service costs 2.4 times more in Iowa than in Kansas. 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
$427
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.