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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | None | $138.04 | $154.88 | $154.88 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $194.98 Typical High $1,513.56 | Facility | None | $162.18 | $194.98 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $2,137.96 | Professional | None | $117.49 | $199.53 | $2,137.96 |
United Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $323.59 | Facility | None | $186.21 | $323.59 | $323.59 |
United Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $199.53 | Professional | None | $93.33 | $138.04 | $199.53 |
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 $67.61 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $27.54 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $20.42 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $13.80 | $15.49 | $15.49 |
Where Oklahoma sits
The same service costs 4.0 times more in Hawaii than in Florida. 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
$191
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.