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 $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $177.83 | Professional | None | $154.88 | $177.83 | $177.83 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $223.87 Typical High $1,737.80 | Facility | None | $186.21 | $223.87 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $1,862.09 | Professional | None | $141.25 | $239.88 | $1,862.09 |
United Setting Facility Modifier None Typical Low $158.49 Median $389.05 Typical High $389.05 | Facility | None | $158.49 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $239.88 | Professional | None | $112.20 | $162.18 | $239.88 |
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 $77.62 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $77.62 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $30.90 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $23.44 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $15.49 | $17.78 | $17.78 |
Where Oklahoma sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 35th of 51
$219
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.