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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $457.09 | Professional | None | $398.11 | $457.09 | $457.09 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $575.44 Typical High $4,073.80 | Facility | None | $478.63 | $575.44 | $4,073.80 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $5,248.07 | Professional | None | $331.13 | $575.44 | $5,248.07 |
United Setting Facility Modifier None Typical Low $181.97 Median $912.01 Typical High $912.01 | Facility | None | $181.97 | $912.01 | $912.01 |
United Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $562.34 | Professional | None | $263.03 | $398.11 | $562.34 |
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 $199.53 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $45.71 | $45.71 |
Where Oklahoma sits
The same service costs 2.5 times more in Montana than in Alabama. 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· 19th of 51
$562
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.