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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | None | $346.74 | $346.74 | $398.11 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $501.19 Typical High $3,630.78 | Facility | None | $416.87 | $501.19 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $4,677.35 | Professional | None | $281.84 | $501.19 | $4,677.35 |
United Setting Facility Modifier None Typical Low $426.58 Median $794.33 Typical High $794.33 | Facility | None | $426.58 | $794.33 | $794.33 |
United Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $489.78 | Professional | None | $229.09 | $338.84 | $489.78 |
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 $173.78 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $173.78 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $69.18 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $39.81 |
Where Oklahoma sits
The same service costs 3.8 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· 27th of 51
$447
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.