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 $398.11 Typical High $398.11 | Professional | None | $346.74 | $398.11 | $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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $501.19 Typical High $3,981.07 | Facility | None | $416.87 | $501.19 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $5,495.41 | Professional | None | $316.23 | $549.54 | $5,495.41 |
United Setting Facility Modifier None Typical Low $501.19 Median $870.96 Typical High $870.96 | Facility | None | $501.19 | $870.96 | $870.96 |
United Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $549.54 | Professional | None | $251.19 | $363.08 | $549.54 |
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 $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $173.78 | $194.98 | $194.98 |
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 $51.29 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $51.29 | $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 4.1 times more in Hawaii than in Kansas. 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· 30th of 51
$501
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.