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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | None | $169.82 | $190.55 | $190.55 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $1,905.46 | Facility | None | $199.53 | $245.47 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $2,238.72 | Professional | None | $151.36 | $263.03 | $2,238.72 |
United Setting Facility Modifier None Typical Low $151.36 Median $426.58 Typical High $426.58 | Facility | None | $151.36 | $426.58 | $426.58 |
United Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $263.03 | Professional | None | $120.23 | $177.83 | $263.03 |
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 $83.18 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $83.18 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $33.88 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $25.12 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $16.98 | $19.05 | $19.05 |
Where Oklahoma sits
The same service costs 2.7 times more in Montana 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· 49th of 51
$200
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.