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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $251.19 | Professional | None | $218.78 | $251.19 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $316.23 Typical High $1,995.26 | Facility | None | $263.03 | $316.23 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $2,511.89 | Professional | None | $158.49 | $288.40 | $2,511.89 |
United Setting Facility Modifier None Typical Low $190.55 Median $436.52 Typical High $436.52 | Facility | None | $190.55 | $436.52 | $436.52 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $288.40 | Professional | None | $125.89 | $190.55 | $288.40 |
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 $109.65 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $109.65 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $43.65 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $32.36 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $21.88 | $25.12 | $25.12 |
Where Oklahoma sits
The same service costs 2.5 times more in Kansas than in Florida. 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· 26th of 51
$275
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.