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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $104.71 | Professional | None | $91.20 | $104.71 | $104.71 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $131.83 Typical High $831.76 | Facility | None | $109.65 | $131.83 | $831.76 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $1,174.90 | Professional | None | $66.07 | $120.23 | $1,174.90 |
United Setting Facility Modifier None Typical Low $102.33 Median $186.21 Typical High $186.21 | Facility | None | $102.33 | $186.21 | $186.21 |
United Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $120.23 | Professional | None | $52.48 | $79.43 | $120.23 |
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 $45.71 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $45.71 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $18.20 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $13.80 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $9.12 | $10.47 | $10.47 |
Where Oklahoma sits
The same service costs 4.1 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· 26th of 51
$105
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.