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 $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | None | $269.15 | $302.00 | $302.00 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $389.05 Typical High $2,818.38 | Facility | None | $316.23 | $389.05 | $2,818.38 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $389.05 Typical High $3,162.28 | Professional | None | $223.87 | $389.05 | $3,162.28 |
United Setting Facility Modifier None Typical Low $281.84 Median $616.60 Typical High $616.60 | Facility | None | $281.84 | $616.60 | $616.60 |
United Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $389.05 | Professional | None | $177.83 | $269.15 | $389.05 |
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 $131.83 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $53.70 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $39.81 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $30.20 |
Where Oklahoma sits
The same service costs 2.6 times more in Hawaii than in Washington, DC. 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· 41st 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.