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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $199.53 | Professional | None | $173.78 | $199.53 | $199.53 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $1,862.09 | Facility | None | $208.93 | $251.19 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $2,630.27 | Professional | None | $144.54 | $251.19 | $2,630.27 |
United Setting Facility Modifier None Typical Low $234.42 Median $407.38 Typical High $407.38 | Facility | None | $234.42 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $251.19 | Professional | None | $117.49 | $173.78 | $251.19 |
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 $87.10 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $87.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $34.67 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $17.38 | $19.95 | $19.95 |
Where Oklahoma sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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· 38th of 51
$209
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.