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 $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | None | $302.00 | $302.00 | $346.74 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $436.52 Typical High $2,754.23 | Facility | None | $363.08 | $436.52 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $398.11 Typical High $3,467.37 | Professional | None | $218.78 | $398.11 | $3,467.37 |
United Setting Facility Modifier None Typical Low $218.78 Median $616.60 Typical High $616.60 | Facility | None | $218.78 | $616.60 | $616.60 |
United Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $398.11 | Professional | None | $173.78 | $263.03 | $398.11 |
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 $151.36 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $60.26 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.20 | $34.67 | $34.67 |
Where Oklahoma sits
The same service costs 2.4 times more in Arkansas 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
$347
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.