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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | None | $112.20 | $128.82 | $128.82 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $162.18 Typical High $1,047.13 | Facility | None | $134.90 | $162.18 | $1,047.13 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $1,288.25 | Professional | None | $81.28 | $147.91 | $1,288.25 |
United Setting Facility Modifier None Typical Low $107.15 Median $223.87 Typical High $223.87 | Facility | None | $107.15 | $223.87 | $223.87 |
United Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $147.91 | Professional | None | $64.57 | $97.72 | $147.91 |
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 $56.23 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $56.23 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $22.39 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $16.98 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $11.22 | $12.88 | $12.88 |
Where Oklahoma sits
The same service costs 3.0 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· 23rd of 51
$141
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.