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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | None | $245.47 | $275.42 | $275.42 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
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 $288.40 Median $354.81 Typical High $2,344.23 | Facility | None | $288.40 | $354.81 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $2,818.38 | Professional | None | $181.97 | $323.59 | $2,818.38 |
United Setting Facility Modifier None Typical Low $281.84 Median $501.19 Typical High $501.19 | Facility | None | $281.84 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $323.59 | Professional | None | $144.54 | $218.78 | $323.59 |
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 $120.23 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $120.23 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $48.98 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $24.55 | $27.54 | $27.54 |
Where Oklahoma sits
The same service costs 3.3 times more in Hawaii than in Delaware. 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· 30th 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.