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 $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $316.23 | Professional | None | $275.42 | $316.23 | $316.23 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $398.11 Typical High $3,311.31 | Facility | None | $331.13 | $398.11 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $3,630.78 | Professional | None | $263.03 | $457.09 | $3,630.78 |
United Setting Facility Modifier None Typical Low $363.08 Median $724.44 Typical High $724.44 | Facility | None | $363.08 | $724.44 | $724.44 |
United Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $457.09 | Professional | None | $208.93 | $295.12 | $457.09 |
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 $138.04 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $41.69 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $27.54 | $31.62 | $31.62 |
Where Oklahoma sits
The same service costs 2.8 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· 32nd of 51
$389
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.